Folks... the fraud and deceit coming out of Obama's Washington... simply mind-boggling.
Christopher Weaver, Anna Wilde Mathews and Tom McGinty writing in the WSJ
* * * * *
At Banner Health’s general hospitals, the rate of heart-failure patients who wind up admitted to the hospital again soon after leaving has been dropping significantly, according to a Wall Street Journal analysis of Medicare billing data. So has the readmission rate for patients treated for pneumonia and three other serious conditions.
The Obama administration has cast such results as a triumph of the Affordable Care Act, which penalizes hospitals that have too many readmissions within 30 days of an inpatient stay.
But this seemingly good news isn’t as encouraging as it appears.
* I'M SHOCKED! SHOCKED, I TELL YOU!
At Banner, based in Phoenix, and at hospitals around the country, more patients are entering or re-entering hospitals under something called “observation status” — a category that keeps them out of the readmission tallies.
Patients on observation status can remain in the hospital for days, and typically receive care that is indistinguishable from inpatient stays...
But under Medicare billing rules, the stays are considered outpatient visits, and as such, don’t trigger penalties under the health law.
The Journal’s analysis of Medicare billing data shows that increases in observation stays can skew the readmission numbers, letting hospitals avoid penalties even if patients continue to have complications and return for repeat visits.
Observation stays generally are cheaper for the government, but in some cases they can lead to big bills that are the patient’s responsibility.
* SMOKE AND MIRRORS, FOLKS...
* LIES AND DECEPTION, FOLKS...
The effect may be to burnish the apparent performance of some hospitals based on what is effectively a bookkeeping change, rather than improved care — and leave the penalty program open to the possibility of manipulation, experts say.
* NO... NOT THE OBAMA ADMINISTRATION...
“The hospitals are responding to the incentive scheme that has been established for them,” said Eric Coleman, a geriatrician and University of Colorado professor. He said the Journal’s findings show that observation stays are “blurring the results of what we think we’re doing, and how effective we think we are.”
The Journal’s analysis found that 319 hospitals — about 10% of the nation’s short-term acute-care hospitals, the type subject to the penalties — contributed half of the overall increase in follow-up observation stays from 2010 to 2013. Among those hospitals, which include 10 of Banner’s, readmission rates for medical conditions subject to the penalty program fell about 14% overall. At the same time, the share of follow-up visits labeled as observation stays rose 156%...
* HA! HA! HA!
* FOLKS... YOU CAN'T MAKE THIS $HIT UP!
Across the roughly 3,500 short-term acute - care hospitals—often referred to as general hospitals — that face the penalty program, the Journal identified a drop in readmission rates of about 9% from 2010 to 2013 for penalty-program conditions. Follow-up observation-stay rates increased about 48%...
In some cases, observation stays can carry a financial sting for Medicare patients. Because such stays are treated as outpatient services, patients face co-pays that can in some cases exceed Medicare’s inpatient deductibles.
An even bigger bite can come when patients are referred to nursing homes: Medicare generally doesn’t cover such care after an observation stay.
(*JUST SHAKING MY HEAD*)
* FOLKS... THERE ARE SERIOUS REPERCUSSIONS ATTACHED TO THE OBAMA ADMINISTRATION'S DECEPTIONS...
“We were shocked,” said Bob Wellentin, 87 years old, a retired teacher in Puyallup, Wash., who said he had never heard of observation stays before his wife spent four days in a hospital after a fall in June 2014. She recuperated for more than two months in a nursing home, costing the couple more than $20,000, according to billing records and receipts. To pay the bills, the couple liquidated a life-insurance policy and cashed in certificates of deposit set aside to pay for their burials.