90-day warranty for your surgery

Well, it has come to this: a hospital system that is selling a 90-day warranty for the surgeries they perform (at the moment, just heart bypass surgery).

Under the typical system, missing an antibiotic or giving poor instructions when a patient is released from the hospital results in a perverse reward: the chance to bill the patient again if more treatment is necessary. As a result, doctors and hospitals have little incentive to ensure they consistently provide the treatments that medical research has shown to produce the best results.

Researchers estimate that roughly half of American patients never get
the most basic recommended treatments — like an aspirin after a heart attack,
for example, or antibiotics before hip surgery. (New York Times)

Under the program/ warranty called ProvenCare which began last year, doctors under the Geisinger Health System have to follow 40 essential steps prior to any bypass surgery. The results of the first year were released last month at a meeting at the American Surgical Association. The results were overall very positive: in-hospital mortality decreased to 0% from 1.5%, readmissions to ICU decreased from 2.9% to .9%, etc.

While we commend the fact that the Geisinger Health System is trying to "get it right" the first time they perform a surgery so as to reduce health care costs, our question is: why not do this to begin with without having to charge insurers and employers an extra charge for this warranty? The warranty sounds great, but the costs will eventually trickle down to those insured (via higher premium health insurance rates). Why should the insured carry the burden of this warranty? Shouldn't hospitals want to give the best pre- and post- treatment to their patients?