Last year, the Lown Institute, a nonprofit healthcare think tank based in Needham, Massachusetts, reported that hospitals performed more than 1 million unnecessary tests and procedures on Medicare patients from 2016 to 2018. Unnecessary tests and procedures can put patients at risk of complications and drive up the cost of care.
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U.S. hospitals performed more than 100,000 surgeries on older patients during the first year of the pandemic, according to a new Lown Institute analysis.
The healthcare think tank relied on Medicare claims data and analyzed eight common low-value procedures. It called the 100,000 procedures unnecessary and potentially harmful in a press release. It found that between March and December 2020, among the most-performed surgeries were coronary stents and back surgeries.
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For the ranking, Lown examined service use measures at more than 3,100 hospitals. Data in the ranking came from the Medicare claims database and spanned 2018 to 2020. Eight common procedures — including hysterectomy for benign disease, coronary stents for stable heart disease and spinal fusion for low back pain — were measured. Four tests were also considered. Hospitals with the capacity to do four or more of the services were ranked.
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Despite the risks posed by COVID-19, hospitals continued to perform eight common, low-value procedures during the first year of the pandemic at a rate similar to 2019, according to a Lown Institute analysis published Tuesday.
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Two-thirds of hospitals in the U.S. are classified as non-profits, yet there is a huge disconnect between the billions of dollars of tax exemptions that many of these institutions receive and how much of those savings goes back into community investment and charity care, as a recent study from the Lown Institute found.
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"There's sort of this conspiracy of silence in which everything goes along pell-mell, merrily business as usual," said Dr. Vikas Saini, president of the Lown Institute, which publishes research on unnecessary procedures. "Hospitals have no incentive to say, 'are you sure everything we're doing is needed?' Hospitals are in the business of collecting revenue, and so it's not that they're deliberately engaging in ripping off communities, it's that they have no incentive to try to be better, and they have plenty of disincentives."
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Health systems across the U.S. made Lown Institute's new rankings lists for organizations where charity care and community investment spending was less or more than the value of their tax exemption.
The rankings, released April 12 by the nonpartisan healthcare think tank, examine meaningful community benefit spending for nonprofit hospital systems nationwide.
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The Lown Hospitals Index 2022 Community Benefit ranking found the Clinic had the fourth-highest fair share deficit among U.S. nonprofit hospitals at $611 million. The fair share deficit is the difference between the estimated amount a hospital system receives in tax breaks versus the amount it directly invests into its community.
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Some of the largest not-for-profit U.S. hospital systems get a bigger benefit from their tax breaks than they pay out in charity care for the poor, implying that society isn’t benefiting much from their tax-free status, according to a new report.
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“It’s important for all of us to start understanding exactly how tax exemptions are working and what we’re actually getting for it,” says Dr. Vikas Saini, president of the Lown Institute. “The dollars we’re not seeing in taxes are dollars that could be spent on education, firefighters, police and safety, nutrition programs—you name it.”
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