Courtesy of Mish.
Obamacare “Observations”
Team Obama brags that that the readmission rate of patients to hospitals has been dropping. It has. And that was one of the goals of Obamacare.
Are congratulations in order?
Not exactly. Medicare enacts a penalty on hospitals that do not meet readmission goals. To meet the new goals, hospitals readmit patients, but they don’t label it “readmission“, they label it “observation“.
Elusive Search for Improvements
The Wall Street Journal explains how Medicare Rules Reshape Hospital Admissions.
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. The goal is to encourage better follow-up treatment so patients can stay out of the hospital—keeping them in better health and whittling down the cost to the government.
But this seemingly good news isn’t as encouraging as it appears. 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, experts say. 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.
Readmissions vs. Observations
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