The problem of quality in health care

Kaiser Health News published an article specifically about hospice care, although the article discusses a problem found throughout the healthcare industry: determining and measuring quality. The context for the article is that for-profit entities have been owning a greater percentage of hospice agencies (from 3.4% in 2011 to 7.3% in 2019). While the increase of for-profit ownership is not inherently problematic, the article discusses some of the ways that for-profit owners may be tempted to cut corners for greater profits.

For-profit institutions can be especially vulnerable to the profit motive and compromise on quality, especially in cases where owners come from a different industry background with the express intention of making a purely financial investment. This problem can be generalized to the healthcare industry in general. Rather than regulate who can own hospice agencies or hospitals, a longer-term solution would be to develop quality metrics that are gathered for each institution that provides care. After all, non-profit owners theoretically could operate their business less efficiently (e.g. on a smaller scale or without as substantial of a capital investment) or might pay their executive team unwarranted salaries, leading their institutions to provide a lower quality of care than corresponding for-profit institutions. However, determining quality metrics that the industry (and patients) agree on can be a very difficult task, and it is also possible that collecting data points for those metrics could be time-consuming. Nevertheless, with sufficient incentives in place, it seems that wrangling agreement for quality metrics is likely a more worthwhile struggle than arguing over which services can be owned by for-profit institutions.