Monday, June 11, 2007

On the blogs: lab waste, hospital competition

On Nature Network Boston, Anna Kushnir lets us in on a dirty little secret: Labs are an environmentalist's nightmare.

"The amount of waste that my lab generates every day makes paper mills look Earth-friendly," she writes reluctantly (while noting it's not her waste bucket at left). "There is nothing I can do about it. I am not willing to risk my samples being contaminated and my experiments failing to save a pair of gloves or spare a pipette."

A Healthy Blog's John McDonough of Health Care For All and Running a Hospital's Paul Levy of Beth Israel Deaconess Medical Center are engaged in a back-and-forth on hospital competition, cost and quality. This follows previous discussions about the power of Partners HealthCare to influence payment rates.

Levy asks. "Since BIDMC has and will continue to have an excellent clinical reputation and very good relationships with community hospitals, multi-specialty groups, and other referring physicians, should we abandon our call for structural changes in the payment system? Would we be better off just living with the current arrangement, i.e., receiving rates that are just below those provided to the dominant provider network?"

McDonough lists financial data for Beth Israel Deaconess and two Partners hospitals, Massachusetts General and Brigham and Women's.

"Yes, BIDMC’s major competitors are bigger and badder," he writes. "Doesn’t seem, though, that BIDMC is doing too shabbily itself. Doesn’t seem like it’s time to take the hankies out."

That said, McDonough asks how to measure quality in hopes of moving the converstation forward.

"There are literally hundreds and hundreds of quality indicators, and each provider would like to get paid for those things it does well, and not get penalized for the things it does poorly," he says. "Who should decide which indicators matter, and which do not?"

Posted by Elizabeth Cooney at 03:52 PM

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