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Originally Posted by TheMentat
Just off the top of my head... Wouldn't providers just cherry-pick patients?
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That's the first thing that popped into my head. Just because a doctor or hospital has "worse" results doesn't mean that's bad care.
Using this "wellness metrics" concept, what's my incentive to take care of a complicated case? Why not just punt them all to the local university center? Make up some garbage about a "higher level of care" not available in the community setting. After all, I'd rather take the otherwise healthy patients with stable disease and perform elective surgeries on them (i.e. 45 year-old healthy male with a history of diverticulitis, now controlled, who wants a sigmoid colectomy to prevent future recurrences), and send the acutely ill ones (e.g. 65-going-on-85 year-old patient with emphysema, poorly-controlled diabetes, morbid obesity, a couple of heart attacks, with three previous intra-abdominal surgeries, now with a diverticular abscess and an acute abdomen) to the tertiary care medical center.
Take care of healthy people (you know, the people who would do well even if they were taken care of by a chimpanzee) and your "wellness metrics" will be through the roof.
Like in gymnastics, diving or figure skating, it's not just about how well you do it, there's also some accounting for degree of difficulty reflected in your final score.