Serota added that there is a need for "risk adjustment emergency department and hospitalization utilization." Too many ED and hospital visits are often described as a "failure" of the healthcare system. But instead of being penalized, hospitals serving at-risk patients, who often use the ED, should be rewarded for providing "intangible services," such as preventative care, social support and educational resources.
In addition, hospitals should be given compensation for providing "enabling services"—including transportation, social and counseling programs, including an obesity prevention focus.
"One quality measure the government doesn't address is obesity," Serota says. "Having reduced obesity is not a quality measure, and that's the biggest health issue facing our country. Yet there's no quality measure around it."
By changing its focus, the government would help "better align quality improvement with what brings value to patients," the Serota commentary states. "Without such a shift, quality measurement—and the ensuring improvement efforts—may continue to shift resources away from where they are most needed. This is something we surely cannot afford."