Iowa Hospitals Give Medicare Patients High Quality Care;
Medicare Gives Hospitals Lowest Payments in the Nation
DES MOINES - Iowa hospitals provide some of the highest
quality care in the nation for Medicare patients, even while the
Medicare payment system reimburses Iowa hospitals with the lowest
payments in the nation, according to the Iowa Hospital Association.
A study of quality of care delivered to Medicare beneficiaries
shows that Iowa remains among the top 10 states. The study, reported
in the January 15 issue of the Journal of the American Medical Association
(JAMA), ranked Iowa sixth in the nation, moving the state up two
places above the ranking it received in a similar study released
in 2000.
While Iowa hospitals' quality of care is recognized
among the best, the state's Medicare payments remain last in the
nation.
"Inequity in the Medicare payment system is an
economic issue for every Iowa business and every Iowan," IHA
President Kirk Norris said. "At a time when everyone is prioritizing
the need to stimulate Iowa's economy, Iowa's citizens directly subsidize
the Medicare program and indirectly subsidize private health insurance
markets in other parts of the United States."
Medicare's reimbursement inequity translates into an estimated 6.5
percent loss for Iowa hospitals on each Medicare transaction, according
to IHA data. If Iowa hospitals were reimbursed enough to break even
on Medicare, about $100 million in additional federal funding would
come into the state.
Similar to the 2000 quality study, the JAMA survey
examined 22 quality indicators abstracted from statewide random
samples of medical records for inpatient fee-for-service care and
from Medicare beneficiary surveys or Medicare claims for outpatient
care. The highest geographic concentration of high-ranking states
is in the Upper Midwest, with North Dakota, Minnesota, Nebraska,
and Wisconsin joining Iowa in the top quarter of the quality ranking.
Notably, four of the 10 worst reimbursed states, including
Iowa, are ranked among the top 10 for quality. This situation is
in contradiction to the Bush administration's claim that it intends
to reward high-quality, cost-efficient providers of care in the
Medicare program.
"While Iowa hospitals can be proud of being a
national leader in quality of care, the blatant unfairness within
the Medicare payment formula remains and is punishing Iowa and states
like Iowa more harshly than ever," Norris said. "President
Bush has twice come to Iowa and promised to make Medicare work better
for Iowa seniors. We need to start seeing progress toward that end."
In addition to the negative impact on Iowa's economy,
low Medicare payments also affect Iowa's ability to attract physicians
and other health care professionals. As one of the state's largest
employers, that is a serious problem for hospitals.
"Iowa already has a health care work force shortage,
and the inequity of Medicare only compounds the situation,"
Norris said. "Clinicians know two things about Iowa: first,
we have a very high number of Medicare beneficiaries as a percent
of our population, and, second, we receive the lowest payments in
the country. When a hospital goes recruiting, that's a lot to overcome."
IHA has been the most vocal and visible advocate for
improving Iowa's Medicare payments. More than 40 Iowa hospital representatives
recently traveled to Washington, D.C. to meet with members of the
Iowa Congressional Coalition.
"Our hospital advocates are working on near-term
strategies to get immediate payment relief from Medicare, and long-term
strategies to make permanent changes in the Medicare system,"
Norris said. "We are fortunate to have some powerfully placed
people in Senator Grassley as Finance Committee Chair and Congressman
Nussle as House Budget Chair. They are in position to be tenacious
on this issue, and that's what Iowa needs."
|
