How CMS Penalizes Hospitals for Finding Blood Clots

Cheryl Clark, for HealthLeaders Media , October 10, 2013

Maynard says Bilimoria's paper "has made a very valid point, and raised awareness beyond what we've been able to do just by saying these measures aren't very good."

Asked for its response to the Bilimoria paper, specifically why it continues to back a quality measure about which providers are so strongly skeptical, Erin Reese, a spokeswoman for the National Quality Forum, replied in an e-mail:

"Any party may request an ad hoc review of any measure as long as there is adequate evidence to justify the review," for example the evidence has changed, implementation results in unintended consequences or material changes have been made to the measure.

"That said, the ad hoc review is available to parties who wish to request one, and the measure you reference seems to fit the criteria stated above."

I had mixed feelings about Bilimoria's paper. My mother suffered a pulmonary embolism while sitting in the lobby of a South Florida cancer treatment center, waiting for her second dose of chemotherapy. Though a code was called and she was revived, she did not survive that event.

No one looked for the possibility she might have a blood clot, though an exploratory surgical procedure she'd had a few weeks earlier put her at even greater risk.

But to have hospital physicians chasing their tales and gaming the system, overtreating some or ignoring risk to escape financial penalty and public shame would not solve this problem. And it certainly wouldn't save people like my mom.

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