Becker's Hospital Review

44 CMO / CARE DELIVERY 1 in 3 Providers Dissatisfied With Healthcare Costs: 4 Things to Know By Megan Knowles N early one-third of healthcare providers are dissatisfied with the prices their patients pay for care while only 13 percent of patients were dissatisfied, revealing a gap in how patients and physicians view healthcare value, according to survey out of Salt Lake City-based University of Utah Health. Here are four things to know about the survey findings. 1. Between late May and mid-July, the University of Utah Health part- nered with Leavitt Partners to explore how patients, physicians and employers define value in healthcare. ey released an online poll that gathered data from 5,031 patients, 687 primary care and specialty physicians and 584 employers. 2. Although all groups agreed the U.S. spends too much on healthcare, 67 percent of patients and 72 percent of employers said they were somewhat or extremely satisfied with the amount they had person- ally paid for healthcare servicesin the past year, which included the costs of monthly premiums, deductibles, co-pays, co-insurance and prescription drugs. In contrast, only 37 percent of physicians were somewhat or extremely satisfied with the price their patients paid. 3. e survey found relatively few physicians identified controlling cost as a top indicator of high-value care. However, when asked what they considered most when making decisions about treatment, 24 percent of physicians said they did not consider cost at all. Fiy-nine percent of physicians said it is their responsibility to discuss costs with patients. 4. "e Value in Health Care Survey makes clear some of the specific ways we lack shared perspectives but also suggest points of conver- gence that can be used to map a path forward," said Bob Pendleton, MD, University of Utah Health's chief medical quality officer. "Both are vitally important in creating a collective vision of how to achieve a value-focused healthcare system." n Inpatient Mortality for Opioid- Related Hospitalizations Sees Fourfold Increase Since '90s By Brian Zimmerman I npatient mortality among individuals hospitalized for opioid misuse increased fourfold from the 1990s to 2014, according to a study published in Health Affairs. For the study, researchers analyzed hospitalization data compiled in the nation's largest all-payer inpatient data- base from 1993 through 2014. Among the data, research- ers identified 384,611 opioid-related hospitalizations. The mortality rate for these patients fluctuated little before 2000. Researchers established a composite average death rate for 1993 to 2000. In that time period, an average of 0.43 percent of patients hospitalized for opioid-related causes died in the hospital. By 2014, the rate had increased to 2.02 percent, or 20.2 deaths per thousand admissions. The researchers identified three possible causes for rising mortality rates among these patients: the increasing avail- ability of highly potent synthetic opioids like fentanyl; the rising rates of heroin use, which have coincided with pre- scription opioid price increases; and more instances of first responders treating less severe cases of opioid poi- soning in the field, leaving the more severe cases to be treated in the hospital setting. "Until community-based efforts to tackle opioid misuse have taken root, treating opioid addiction and better equipping hospitals to care for patients with increasingly severe opioid abuse may help the healthcare system com- bat the rising mortality rates of patients hospitalized for opioid use disorders," concluded the study's authors. n MIPS Predecessor Worsened Care Disparities, Study Finds By Brian Zimmerman C MS' Value-Based Payment Modifier program, which sought to improve care value by transitioning away from fee-for-service models to value-based care, in- advertently shifted money away from physicians who treat poorer and sicker patient populations, according to a study published in the Annals of Internal Medicine. For the study, researchers assessed Medicare spending rates and quality performance among clinicians that took part in the CMS program between 2013 and 2016. Researchers compared these variables to those from clinicians who did not participate in the program. Quality measures assessed in the study included mortality rates and 30-day readmissions. While researchers found no evidence the program im- proved care quality with its reimbursement incentives, they did determine the program funneled money away from phy- sicians who treated sicker, poorer patients to fund bonuses for physicians treating more affluent, healthier populations. "As long as these programs do not account adequately for patient differences, which is very difficult to do, they will fur- ther deprive practices serving low-income populations of important resources," said Eric Roberts, PhD, assistant pro- fessor of health policy and management at the University of Pittsburgh Graduate School of Public Health and lead author of the study. Researchers questioned whether the successor to the 2013-16 CMS program — the Merit-based Incentive Pay- ment System, which took effect in January — will yield dif- ferent results. n

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