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Not in all cases. The Nebraska legislature passed a law prohibiting "drive-through deliveries". So at the same time a 30-something relative of mine had a baby and got to stay in the hospital 48 hours, my 78 yo mother-in-law didn't get to stay 48 hrs after gall bladder surgery, when her caregiver at home was her 88 yo husband! A lot of Medicare patients have NO caregiver; they're on their own.
I just had Gall Bladder surgery and was out within 2 days,so has my mother and my sister in law...its not a huge surgery..
Not in all cases. The Nebraska legislature passed a law prohibiting "drive-through deliveries". So at the same time a 30-something relative of mine had a baby and got to stay in the hospital 48 hours, my 78 yo mother-in-law didn't get to stay 48 hrs after gall bladder surgery, when her caregiver at home was her 88 yo husband! A lot of Medicare patients have NO caregiver; they're on their own.
In most cases the Physican would order home health or discharge to a skilled nursing facility, lack of caegiver is not sufficient to justify more acute days.
Starting tomorrow (10/1) another Obamacare law takes effect.
Hospitals will be charged for medicare readmissions within 30 days of discharge.
The average fine is $125K per facility.
Only three conditions though are being monitored for these fines: heart attacks, heart failure and pneumonia.
What I don't get though is that hospitals will be held accountable if the patient doesn't do what they are supposed to do or if the patient doesn't take their medicine. Even if it's 100% the patient's fault they are readmitted the hospital will get the fine.
Hospitals to be fined for readmitted patients
As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama's health care law to improve quality while also trying to save taxpayers money.
About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year, according to government estimates.
Thing is, I've worked for a few hospitals with higher-than-average 30-day readmissions, and many times it IS an issue of quality of care causing the readmissions, from discharging a patient before they were completely stable from surgery, CVA, trauma. Other times it's patients not adhering to discharge instructions (like dietary restrictions)/medications/wound care, unexpected surgical complications, iatrogenic infections. In many hospitals, follow-up care and discharge planning were quite different than at hospitals showing better outcomes. Also at issue are the doctors themselves as well as nursing staff.
For X number of hospitals with Medicare CHF patients, for example, if 80% of them do not show a pattern of 30-day readmissions but 20% consistently does, someone needs to find out exactly why that 20% of hospitals is achieving that outcome.
Quote:
Originally Posted by HappyTexan
I don't disagree with you. But there is no medicare money set aside for studies.
Looks like they will force quality improvement by penalizing them for readmissions.
And there's not much that can be done about patients that do not heed the advice and get readmitted is there ? Yet the hospital will suffer because of it. As far as discharging patients before they are fully recovered, doesn't medicare specify how many days they will cover ?
Quote:
Originally Posted by rayneinspain
I see Medicare covering home health services every day.
Like I said before, it is those hospitals with readmission rates far above the norm that beg the question of WHY. Either their patient base is far more frail and ill than the rest of the hospitals in neighboring communities (or within the same city), or something is amiss with direct patient care or care upon discharge.
I was wondering why they were pushing us to get my dad into an assisted living rehab facility, on Friday.
My girlfriend's mother was in the hospital for several days and they didn't want to release her. This was just last week. She's home and doing well now, despite their insistence that she stay. Now I understand why they kept pushing so hard.
No way will they get to 0 readmissions.
Reduced payments and $125K per readmittance.
Hospitals' Readmissions Rates Not Budging - Kaiser Health News
The most recent rates are based on readmissions spanning July 2008 through the end of June 2011. The Medicare data published Thursday on its Hospital Compare website showed that 19.7 percent of heart attack patients were readmitted within 30 days of discharge, a drop of only 0.1 percentage point from the previous year’s figures, which were based on the years 2007 through 2010. The data show that 24.7 percent of heart failure patients were readmitted, also a 0.1 point decrease. Pneumonia readmissions actually increased by 0.1 percentage points, to 18.5 percent of all Medicare pneumonia patients.
And zero readmissions is not the goal.
Medicare Fines Over Hospitals' Readmitted Patients : NPR
**As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. . . . Also, for now, hospitals are only being measured on three medical conditions: heart attacks, heart failure and pneumonia.
Medicare Fines Over Hospitals' Readmitted Patients : NPR
**As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. . . . Also, for now, hospitals are only being measured on three medical conditions: heart attacks, heart failure and pneumonia.
Has medicare defined what number of patients constitute "too many" ?
I didn't read anywhere that they would not be fined until they reached a certain number. Re-admissions will cost them $125K each.
What’s interesting is that this was the basis for the ObamaCare argument to begin with – people who are uninsured who are dying without sufficient care. So now the insurance barrier is removed and now the government starts penalizing the care providers. So you are taking money out of the hospitals ability to care for the patients.
Government needs to be removed from the revenue stream of the health care industry.
This is a stealth way to save money by limiting care to Medicare patients. The government will punish the doctors for providing too much care, in hopes that the doctors will be forced to cut back on the numbers of admissions. The government will have clean hands, because the doctors and hospitals will be to blame, if they cannot magically come up with a way to treat patients with a one-visit-wonder-cure.
Has medicare defined what number of patients constitute "too many" ?
I didn't read anywhere that they would not be fined until they reached a certain number. Re-admissions will cost them $125K each.
It's just an arbitrary number, which means the HHS secretary can just redefine it any time she wants, with a new arbitrary figure.
This is a stealth way to save money by limiting care to Medicare patients. The government will punish the doctors for providing too much care, in hopes that the doctors will be forced to cut back on the numbers of admissions. The government will have clean hands, because the doctors and hospitals will be to blame, if they cannot magically come up with a way to treat patients with a one-visit-wonder-cure.
Before you drink the conspiracy Kool-Aid, you should know the facts. Readmission has been a problem for years, tied to the "Quicker and Sicker" discharge policies. I think it's good to get hospitals, and doctors, who are the ones who write the discharge orders, to look at this issue.
This is a stealth way to save money by limiting care to Medicare patients. The government will punish the doctors for providing too much care, in hopes that the doctors will be forced to cut back on the numbers of admissions. The government will have clean hands, because the doctors and hospitals will be to blame, if they cannot magically come up with a way to treat patients with a one-visit-wonder-cure.
Non-Medicare patient readmissions? Fine and dandy.
Medicare patient readmission? NO WAY!!! Too bad you got old; you're screwed.
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