Earlier this year a famous group of researchers did a careful study on the relationship between surgical complications and hospital finances. Their findings should jolt you:
The average hospital makes money when patients suffer complications from procedures.
This is outrageous. It is fee-for-service at its worst.
The first thought that popped into my mind after reading this study was how healthcare policy might improve the care of patients with AF.
An AF doctor spends oodles of time undoing well-reimbursed medical care. We untangle knots. (Recall that AF patients are not a tranquil lot.) Things that entangle include:
- Overly aggressive and reflexive use of IV-diltiazem drips;
- Carte blanche to order diagnostic tests;
- The entrenched practice of extrapolating data on oral anticoagulants to the IV/SubQ variety–and extending hospitals stays for AF.
Such disruptive care makes money in the fee-for-service model.
I often wonder what would happen if hospitals and doctors received a fixed amount of money to care for a patient with AF? Would this make my job easier? Would it foster wiser team-based care? Would it improve outcomes?
Believe it or not, I have answers to these questions. I hope you want to read them.