Did CDC chief hint hospitals are inflating Covid-19 death count? 'Perverse incentive' could lead to high toll
Hospitals in the United States have a monetary incentive to inflate their count of coronavirus fatalities, said Robert Redfield, the director of U.S. Centers for Disease Control and Prevention, after being questioned during a House panel hearing on Friday, July 31.
Redfield's comments came during a hearing by the House Oversight and Reform Select Subcommittee on the Coronavirus Crisis and were made in reference to a previous statement by Rep. Blaine Luetkemeyer, the incumbent U.S. Representative for Missouri's 3rd congressional district.
On July 2, during a previous hearing entitled "The Administration’s Efforts to Procure, Stockpile, and Distribute Critical Supplies" in the Select Committee on the Coronavirus Crisis, Luetkemeyer had asked Admiral Brett P. Giroir, M.D., Assistant Secretary for Health at the Department of Health and Human Services (HHS) about states reporting inflated COVID-19 fatality numbers.
"There are reports -- and I have been talking to medical professionals -- that there’s been misreporting of deaths for people who may have been involved in, for instance, an auto accident but had COVID in their system, and that death’s then being reported as a COVID death because there apparently is perverse incentive to do that," Luetkemeyer had said, according to a press release on the hearing on his website. "The hospitals get paid more for a COVID death than they do for an auto accident."
Giroir seemingly confirmed the assertion and said such a scenario was likely because the CDC depended on local coroners for their numbers. "The CDC that gathers the statistics is completely dependent on the reports of the local coroners... Yes, there appear to be some misincentives to over-code," he responded.
During Friday's hearing, Redfield was asked to comment on Luetkemeyer's claim as well and said it was possible since this inflation in numbers was something they had seen during previous epidemics as well.
"I think you’re correct in that we’ve seen this in other disease processes too, really in the HIV epidemic, somebody may have a heart attack, but also have HIV -- the hospital would prefer the [classification] for HIV because there’s greater reimbursement," he said. "So I do think there’s some reality to that."
However, he assured the subcommittee that the CDC reviewed the death certificates they received. "When it comes to death reporting, though, ultimately, it’s how the physician defines it in the death certificate and … we review all of those death certificates."
"So I think, probably it is less operable in the cause of death, although I won’t say there are not some cases," he added. "I do think though [that] when it comes to hospital reimbursement issues or individuals that get discharged, there could be some play in that for sure."
His appearance followed reports that more than 1,000 Americans died from the coronavirus on Thursday, July 30, the highest number of daily coronavirus deaths in more than a month. The number of confirmed coronavirus cases in the U.S. is close to 4.5 million, according to the Covid-19 dashboard by Johns Hopkins University. More than 152,000 people have died from the virus since the pandemic began.