[dmek25]

Originally Posted by Schneed10

Dmek, with all due respect, you apparently know nothing on how pay for performance works. Quality is not "judged" or "graded" by someone who comes in and peeks under the hood of your hospital. It is judged by hard numbers standardized within the industry:

- % of people dying compared to the expected death rate
- % of patients receiving unplanned return to surgery
- % of patients discharged within a predetermined time frame appropriate for their illness

You either meet those numbers or you don't, it's not subjective. If you meet them, IBC and Aetna give you a 5% increase on your reimbursement rates next year. If you fail, they only give you a 2% increase. Cut and dry. It's widely regarded as one of the best innovations to come about in healthcare reimbursement recently.

this is where the issue is. you have to meet certain " goals " to get the reimbursement. if this happens, there will be an accountant in every hospital in charge of the numbers. those numbers will be scrutinized over and over again to make the " goal " you probably know as well as i do that anyone can make numbers look and say anything that they want. im lucky. i have a top 25 hospital right here in my home town. i have access to some of the very best care available.