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Here come the penalties

Posted: Oct 7, 2012

Hospitals who re-admit patients within 30 days after they were discharged will now have to, under an Obamacare provision, pay fines as of October 1, 2012, which could force hospitals to slash programs that help the elderly, the poor, and the chronically ill. -- Tony Lee;

Its about appropriate quality patient care and I am happy about that - balderdash

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Time to recycle the talking points, eh? We all know that in these situations the patients were kicked out of the hospital too soon without proper follow up. The hospitals and discharge planners will learn to do proper followup before they slash anyone's profits. Cry me a river.

they get kicked out too soon becx... - dh

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Medicare established such ridiculously low payments that the hospitals are writing off millions & billions as it is. They would all literally go broke and fail if they kept all patients for the appropriate time when they don't get paid! All the insurance companies follow the government's lead on this. Medicare started it and they all followed suit.

That's gonna hurt the hospital I work for big time. - Zville MT

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I type for the psych unit and there are a lot of repeat admits (some because they are homeless and have nowhere else to go and some won't stay on thier meds after discharge), but when you're suicidal, having panic attacks, or manic episodes, sometimes you need to be admitted more than once in a 30-day period, regardless of your medication. It may keep out what one of my doctors call "frequent flyers," but there may be some people who legitimately need help that now won't get it because it'll be too expensive.

Don't feel like doign the research .... - me

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...but I seriously doubt that psychiatric hospitals would be fined under this. Psych is so different than medical-surgical.

Hospitals now are literally killing so many that it's dangerous - to be in them. Fixing this is good. NM

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x

I have a dream: Next time I visit someone I don't have to - TELL clinicians to wash their hands.

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Especially when my 100-year-old aunt was in the hospital for 10 days during the H1N1 flu outbreak. They initially thought she might have it and put her on the respiratory floor with other people who did have it and other nasty things. I didn't usually know if they washed their hands coming in, but I certainly knew when they weren't before heading for other patients. That's when I started making it a principle to tell them they needed to wash their hands when coming in. If they had after examining the last patient, they said so. And they started usually washing on the way out.

Having once worked in risk management, I'm pretty sure it was more that the whole unit started stepping carefully around me rather than getting religion about better hygiene. Nice people to chat with, but! I'm glad negligence is being restructured to COST hospitals money instead of making it.

It will hopefully force....sm - VTMT

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hospitals to improve programs that help the elderly, the poor, and the chronically ill so they can avoid rehospitalization.

What sorts of programs would that - be, and what methods

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would be used to pay for these programs? The idea sounds well and good, but are you suggesting programs that are going to cost the hospital more money and still have the possibility of penalties?

They're in place, but right now the focus is moving people - out of the hospital and finding sources

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of payment. Don't forget, efficient healthcare delivery ultimately saves money (which then goes to either profits or some crying need). Only some hospitals are for profit, though. Many are still operated for the good of the community and their patients. What works best for the patients and their community IS what is best.

As for investors who saw this field as a way to make money off the suffering of a captive market who'll sacrifice everything to make it stop, do we really care if their profits drop? Maybe we'll see a reverse of the charitable nonprofits taken over by business of the 1980s.

I'm still uncertain of what the programs are - that are in place, and

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wondering why fiscially it is in the best interest of a hospital to move patients out. I love the idea of what works best for the patient and communities is best, but Medicare is not always going for what is best for the patient. It is about the bottom line. I'm sorry but I have very little faith in Medicare and how they care for the people. They want to tell a facility that a patient can only be inpatient for x amount of days for this dx, and then come back and take money from them when sometimes life just happens. If there is actual neglect, more power to them.

I do care about how this effects the hospitals as I work in the medical field and am basically paid by insurance reimbursments.

Yep, to the tune of $125,000 minimum up to 3% of Medicare payments. - backwards typist

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It's going to change health care as we know it and it's not going to be all good. The people that will be hurt the most are the elderly. Yet Obama stated Ryan wants to "throw grandma off the cliff?" That's exactly what this rule will do.

Those with unstable illnesses like heart attacks, strokes, and/or respiratory problems will make the hospitals/doctors nervous Nellies and some may even push the patients to nursing homes instead.

Those hospitals that cater to the elderly and the poor, such as large teaching hospitals that are affiliated with universities, will be negatively impacted the most. Industry officials say they have misgivings about being held liable for circumstances beyond their control. They also complain that facilities serving low-income people, including many major teaching hospitals, are much more likely to be fined, raising questions of fairness.
"Readmissions are partially within the control of the hospital and partially within the control of others."

The penalties gradually will rise until 3 percent of Medicare payments to hospitals are at risk. Medicare is considering holding hospitals accountable on four more measures: joint replacements, stenting, heart bypass and treatment of stroke. These are usually your elderly parents, grandparents, and yourself.

Reading one article, a Dr. John Santa compares hospital care to car warranties. Huh? How does he equate a new knee or stent to a car warranty? How would a hospital know if that item will break or something else go wrong with an artificial part within 30 days? Will they be suing the manufacturer? Doubt it will help because that patient will have to be readmitted to have the part exchanged if within those 30 days and the hospital will still get dinged by the government. I doubt the rules will allow this excuse. Will the hospital keep the patient 30 days to make sure the artificial part is working correctly or will the hospital refuse to fix the problem until AFTER the 30 days? I vote for the latter.

The only good thing I can see coming out of this is people will be able to see if their local hospital is on this list of performance data later this month since they've been crunching the numbers and if so, can hopefully find a better hospital.

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