How a new Medicare program will impact your hospital care - Fox 28: South Bend, Elkhart IN News, Weather, Sports

How a new Medicare program will impact your hospital care

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"The whole idea of the Medicare Program is a good one. In that it aligns incentives to try to get hospitals and Doctors to improve quality and that seems to be a good thing and it does work," said Dr. Larry Allen.   

Dr. Allen is the chief Medical Officer at IU Health Goshen. He's optimistic about this new phase of the affordable Care Act. Simply put, the program will penalize hospitals with the highest rates of infection and complications like bed sores. Dr. Allen says the program isn't that new. 

"We're already being measured on all the things they're going to do so this is almost just adding more financial incentive so it's new, but yet these measures are things we've been following for a long time," Dr. Allen said. 

He says, so far, similar measures are working. In the last two years, Medicare has penalized several Michiana hospitals for high readmit rates and other quality assessments. But, in April, only one area hospital was on Medicare's preliminary list for sanctions. Personal injury lawyer, Edward Chester, takes this as a good sign for his clients.

"That tells me that the Medicare Program is working exactly like it was intended to work," Chester said.

With the addition of the Hospital-Acquired Condition Reduction Program in the Fall, Dr. Allen says hospitals could be at risk of losing up to between 5-6% of their Medicare funding. The initiative isn't without controversy, though. Some critics say penalties could mean less funding that would help hospitals improve patient care. Dr. Allen says he doesn't think the small percentage hospitals would lose would really make an impact.

"I think we're really at the beginning of this and so, like it or not, no one should be discouraged by being encouraged to do the right thing and have safety and quality in your institution," Dr. Allen said.

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