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Boston Globe Letter: Well-intended Medicaid policy poses risk for patients

Well-intended Medicaid policy poses risk for patients

By Jonathan Volk
Boston Globe Letters

LIZ KOWALCZYK reported on Medicaid’s plan to cut payments to many of Massachusetts’s best hospitals because of higher-than expected readmission rates (‘‘State to penalize hospitals that readmit too many patients,’’ White Coat Notes, Sept. 22). This policy has reasonable intentions but potentially dangerous consequences. If instituted, it may encourage physicians to keep patients in the hospital longer than necessary in order to minimize readmissions.

While every effort should be made to prevent avoidable readmissions, patients should also be aware that staying in the hospital longer than necessary can be dangerous. The hospital is often not the safest place for patients. As an infectious disease physician, I have observed devastating infections from hospital acquired pathogens. Despite increasingly vigilant infection control efforts, hospitals remain apetri dish of pathogens, and pose a significant health risk for already weakened patients.

I fear that a policy such as the one designed to minimize unnecessary Medicaid expenditures lacks the necessary nuances to improve patient care and, in fact, may have grave outcomes.

Dr. Jonathan Volk,