Hospital Payment Methodology Radically Changed Overnight: Hospitalists WIN!

(HNN)  The Centers for Medicare & Medicaid Services (CMS) announced Friday, December 17, 2011 they are making radical changes to hospital payment methodology.  For several years, CMS has warned hospitals to improve their inpatient hospital patient satisfaction scores, as defined through the  Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey, or risk losing millions of dollars in federal funding.  As part of their compliance efforts, hospitals have been paying consulting organizations millions of dollars to teach their doctors and nurses how to be nice. 

All this is about to change after The Happy Hospitalist filed a Freedom of Information request on the 2010 Patient Protection and Affordable Care Act (PPACA). Since nobody has actually had the time or the resources to read PPACA, through his request, Dr Happy has discovered what the law currently demands is much different than its original intent.
"I was as shocked as anyone to discover what the Act actually says.  It took my breath away!", said Dr Happy.
While hospital satisfaction scores were initially intended to define hospital payments,  the Society of Hospital Medicine (SHM), home to the fastest growing physician specialty in this country, used their clout and access to truck loads of corporate money, to force changes to the Act.  By changing the word hospital to hospitalist, SHM has effectively and radically changed the landscape of hospital health care delivery in this country.   Instead of  hospital satisfaction scores, hospitals will now depend on hospitalist satisfaction scores to determine  how hospitals get paid by Medicare.  In conjunction with CMS and in  preparation for this landmark legislative change , SHM has agreed to give The Happy Hospitalist a sneak preview of their hospitalist survey result and recommendations for how hospitals can comply with this rapidly changing hospital payment methodology.

Beginning January 1st, 2012, MedPac has recommended to CMS that  hospitals take the following actions to improve hospitalist satisfaction scores and continue to provide hospitalists with an excellent practice environment as this someecard helps to explain.  Below that you can find dozens of other newly implemented rules that will change hospital payment methodology forever!  This original Happy Hospitalist ecard helps explain.

"Due to new hospitalist satisfaction initiatives, I am no longer providing consults for other physicians wearing scrubs without an undershirt.  Just so you know."

Due to new hospitalist satisfaction initiatives, I am no long providing consults for other physicians wearing scrubs without an undershirt.  Just so you know doctor ecard humor photo.

  • Ban hospitalist admissions for missing dialysis
  • Ban texting without patient information
  • Ban history and physical
  • Ban E&M coding
  • Ban scrubs without an undershirt
  • Ban hairy arms
  • Ban the smell of melena
  • Ban diarrhea
  • Ban Coumadin
  • Ban agitated dementia
  • Ban all medications with black box warnings.  Did you know Tylenol has a black box warning?
  • Ban hospital informed consent.  Just tell the nurses to have the patient sign here. Saves everyone time.
  • Ban nurses who smoke.  
  • Ban doctors who smoke
  • Ban interns.  They need more sleep.
  • Ban doctors grandfathered in for their boards. 
  • Ban coughing
  • Ban otoscopes.  
  • Ban homeless people that need 12 weeks of IV antibiotics
  • Ban doctors who put patients without prescription drug coverage on Pradaxa
  • Ban doctors who order Keppra on patients with just enough money to buy their smokes
  • Ban Joint Commission days. No hablo English.
  • Ban banning coffee at the nurses station.
  • Ban direct admits for uninsured surgical patients who need surgery without talking with a surgeon first
  • Ban eye-to-eye contact
  • Ban missing teeth
  • Ban Levaquin. 
  • Ban order sets that say call hosptialist for low urine output
  • Ban calls for transfusion reactions
  • Ban ordering labs that require a dictionary to spell correctly.
  • Ban fake seizures
  • Ban medication order that are phonetically spelled  and don't actually exist
  • Ban bad medication reconciliation
  • Ban 10/10 pain.
  • Ban clean catch urinalysis
  • Ban doctors who use newly approved drugs as they will invariably be pulled from the market three months later
  • Ban family initiated RRT calls
  • Ban calls for critically low calcium levels.  There is no such thing
  • Ban doctors who don't do a discharge summary until the patient's next admission to the hospitalist service, three months later
  • Ban missing orders with the response "I don't know what happened to them"
  • Ban under stuffed charts
  • Ban read back of verbal orders, in triplicate
  • Ban that guy who writes his notes in pink ink.
  • Ban bad handwriting
  • Ban consults for constipation.  I'm backed up with other stuff.  I don't have time.
  • Ban patient's food and drink in the patient room.  Too dangerous.  They might get sick.
  • Ban family visits during rounding hours.
  • Ban patient's from trying to set up their niece with the doctor.
  • Ban the stench of smoke smell in the hospital.  
  • Ban body odor
  • Ban double layered hospital gowns
  • Ban bad breath
  • Ban the smell of cafeteria vegetables
  • Ban quiet hour.
  • Ban missing patient charts
  • Ban hospital construction
  • Ban clocks 
  • Ban "hospitalist to follow" consults for fibromyalgia.
  • Ban preoperative cataract consults
  • Ban high expectations
  • Ban lack of common sense
  • Ban lack of critical thinking
  • Ban  lack of thinking
  • Ban bandanas
  • Ban doctor lots without a covers
  • Ban psychiatric admissions
  • Ban social admits
  • Ban admits for too weak to go home.
  • Ban laziness
  • Ban pages that start with "I just thought you should know"
  • Ban family who want you to call them on the phone
  • Ban family who want you to call their doctor relative four times removed
  • Ban patients who's 76 year old retired dermatologist son wants to know why you haven't consulted the pulmonologist for simple CAP in their 99 year old demented, wheelchair bound mother-in-law.
  • Ban consultants consulting other consultants
  • Ban robot medicine
  • Ban Medicaid
  • Ban drug reps, but not their free food
  • Ban 22 gauge IVs
  • Ban voice mail navigation systems
  • Ban admissions for chronic back pain
  • Ban admissions for chronic ...
  • Ban parents of grown children
  • Ban cherry picking PCPs
  • Ban bilateral cellulitis.  There is no such thing.
  • Ban calls asking if I see 16 year olds and why I don't
Through rigorous statistical analysis, SHM has determined that hospitals that can comply with these 80 plus hospitalist satisfaction techniques will get paid 99.99% of the time. If you want to get paid, keep your hospitalists happy!  CMS is currently accepting further public recommendations on how to improve hospitalist satisfaction scores.

This article is copyright protected by the Happy News Network. If this is the kind of news you believe to be true, please seek help immediately from your travel agent.  This post is for entertainment purposes only and likely contains humor only understood by those in a healthcare profession. Read at your own risk.

Print Friendly and PDF