October 6, 2011; Source: Technorati | A study released Wednesday by the  Commonwealth Fund in Health Affairs warns that an unanticipated consequence of the health care reform act may be the failure of hospitals in communities serving a poor and elderly black populations. The study has looked at 3,229 hospitals, rating 122 as “best” and 178 as “worst”.The category of “worst” was over-representative of the south.  Among other things they found that those hospitals rated “worst” have twice as many poor and elderly black patents as the “best” hospitals, and their patients are more likely to die of heart attacks and pneumonia.

Dr. Ashi Jha warns of risks beyond the obvious in these findings saying that the new health care law will provide consequences for inadequate care by withholding some portion of their reimbursement and that this may force some hospitals out of business presumably leaving poor communities without sufficient hospital beds.

“These hospitals are going to have a much harder time in the new funding environment,” said Dr. Ashish Jha of the Harvard School of Public Health, who led the study. “I worry they’re going to get worse over time and possibly even fail. I worry that we’re going to see a bunch of that happening over the next three to five years.”

Don Berwick, the nation’s Medicare Chief indicated that they are aware of the problem, saying that the new law rewards institutions for their rate of improvement, not just for reaching desired  goals. This means, he said, that hospitals that start farther at a care deficit get rewarded for working to catch up and, he points out, the law also offers funding  for hospital improvement programs. “We know they can improve,” even if they treat sicker or disadvantaged patients, Berwick said. “There are examples of safety net hospitals that are some of the best in the country.”—Ruth McCambridge