Value-based care may leave teaching hospitals behind

Healthcare needs academic medical centers to drive the innovations and transformation processes currently underway in the industry, but the nature of present-day pay-for-performance measures leaves many such hospitals in the dust, argues a commentary in The Washington Post.

It's difficult to quantify the areas in which teaching hospitals excel, writes David Silbersweig, M.D., chairman of the Department of Psychiatry at Brigham & Women's Hospital in Boston. It's easier, Silbersweig writes, to measure outcomes such as readmissions; it's much more difficult to quantify the frequency with which a hospital makes the correct diagnosis or the reasons for a referral to another hospital.

A "perfect economic storm" is brewing for academic medical centers due to several factors, according to the commentary, including declining clinical reimbursements. unstable federal funding and reduced investment from pharmaceutical companies. Moreover, he writes, teaching hospitals tend to provide bigger shares of unpaid or under-reimbursed care.

"There is a reason why even those decrying the expense of teaching hospitals flock there when their own families are seriously ill," Silbersweig writes. "They understand that the place where leading faculty and the brightest trainees come together in the most selective programs is the place where the most is known, practiced and taught concerning their conditions and how to treat them."

The commentary comes in the wake of a recent report in The New York Times that found federal incentives for hospitals often punish teaching hospitals for heightened vigilance on hospital-acquired infections, as this naturally leads to reporting higher rates, FierceHealthFinance previously reported.

To learn more:
- read the commentary

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