Saturday, June 13, 2015

Do You Think You're Discharged From Hospitals Because You're Ready? THINK AGAIN!

Hospitals Discharge Patients to Maximize Medicare Payments, Study Finds
Long-term-care hospitals discharge a disproportionately large share of Medicare patients during a window when they stand to make the most money from reimbursements under the federal program, according to a study in the journal Health Affairs.
The Centers for Medicare and Medicaid Services 
headquarters in Woodlawn, Md. 
Photo: Jay Mallin/Bloomberg News
The new study, which focuses on patients who were on ventilators, echoes findings in an analysis by The Wall Street Journal that broadly examined long-term-care hospital claims paid by Medicare and found the same pattern across all types of patients. In the new study, the researchers said their findings “confirm that…payment policy created a strong financial incentive for long-term-care hospitals to time patient discharges to maximize Medicare reimbursement.”
The findings are troubling, said Jack Needleman, one of the study’s authors and a professor at the University of California, Los Angeles’s Fielding School of Public Health.
“Those look like decisions that are not driven by patient need or what is in the best interest of the patient,” he said.
The pattern identified in the study is tied to Medicare’s payment structure for the nation’s approximately 400 long-term hospitals, which focus on treating patients who need intense care for a prolonged period and are reimbursed under different rules than general hospitals. The long-term hospitals typically receive smaller payments for what is considered a short stay, until a patient hits a threshold. After that threshold, payment jumps sharply, to a lump sum meant to cover the full course of long-term treatment. The threshold varies depending on the patient’s condition—for the ventilator patients examined in the new study, it was 29 days.
Read the the rest of the story HERE.

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