Leapfrog starts to expose the high cost of hospital rework

The Leapfrog Group is riling up hospitals with a hidden surcharge calculator designed to show employers how much of their health care premium is devoted to  paying for medical errors at the hospitals where their employees obtain care. The principle behind the calculator is that hospitals bury the costs of errors in their overall rates and that employers should at least understand what they're paying for.Of course hospitals aren't happy about the calculator. And to help blunt the impact of the Leapfrog initiatives, The American Hospital Association has come out with a list of methodological criticisms. That's fair enough. Of course the Leapfrog data --like any in health care-- won't be perfect. But I hope this initiative leads to a broader discussion.Last year I compared hospitals with factories. When a hospital makes a mistake and turns out a poor quality product that product generally has to be reworked before it's sold, which adds cost. When it is sold, it's sold for market price. And if the product can't be reworked it gets scrapped and not sold. Factories whose processes are poor become uncompetitive and close down. In contrast, if a hospital makes a mistake it can often charge for the cost of the rework. Hospitals with poor processes can make as much or more money as those with high quality processes, at least in today's world.There are caveats to this analogy, but the basic idea is sound.Congratulations to Leapfrog for putting this tool out there.  -----------------By David E. Williams of the Health Business Group.