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Hospitals scramble to limit readmissions,
avoid new penalties

News Observer [Raleigh,NC], by John Murawski

Original Article

Posted By:Fiesta del sol, 11/25/2012 2:10:43 PM

The patient – decked out in non-skid footies, a loose hospital gown and a breathing tube – prays she’s finally on the mend. At age 81, Juanita King had logged nearly five weeks at WakeMed Hospital since October after her breathing became so labored she had trouble walking.(snip)WakeMed, along with hospitals across the country, is scrambling to keep patients like King from coming back. Under federal penalties that kicked in Oct. 1 as part of the Patient Protection and Affordable Care Act, hospitals lose Medicare reimbursements if their patients are readmitted at an excessive rate.

Comments:
I bet Juanita is sure glad she hasn´t had to appear before a death panel....yet.

  

Post Reply  

Reply 1 - Posted by: veritas, 11/25/2012 2:27:49 PM     (No. 9033291)

... and necessary re-admissions will not be made as a matter of self-preservation. Wrong, and sometimes won´t be conscious, but it will happen.

The Law of Unintended Consequences trumps the best of intentions every time.


Reply 2 - Posted by: bhkat, 11/25/2012 2:34:04 PM     (No. 9033299)

The hospitals will figure out that having patients dying quickly at home will prevent readmissions for the same problems. I hope seniors and people on Medicare will realize that AARP, Obama, and the dims are responsible.


   

 

  


 
Reply 3 - Posted by: Coy860, 11/25/2012 2:44:54 PM     (No. 9033307)

In the comments section, it is of note that people are actively critical of HOW the patients live. Real buttinskis..I see a lot of this, other people more concerned about what their neighbors earn, how their neighbors eat, drink, smoke, etc.
I say the stress of trying to live everyone else´s lives for them is harmful to their health.
Live and let live for gosh sake..that used to be the American way.
Are you going to tube feed milk into children so that they don´t have broken bones? Deny them red meat, or whatever the anti-food fad is this day?
Too many people are suffering from Moochelle Obama syndrome.


Reply 4 - Posted by: zephyrgirl, 11/25/2012 2:47:41 PM     (No. 9033310)

I guarantee you this will not turn out well for seniors.


Reply 5 - Posted by: whyyeseyec, 11/25/2012 3:03:40 PM     (No. 9033328)

Emergency rooms still cannot deny treatment....


Reply 6 - Posted by: bob913, 11/25/2012 3:10:00 PM     (No. 9033336)

My cousins husband works at a hospital and he thinks obamacare will be good as the illegals they treat will now have their bills paid for... He lost a hospital job because the illegals were overloading the system.

He is also a liberal, a liberal with others money.


Reply 7 - Posted by: Safari Man, 11/25/2012 3:24:53 PM     (No. 9033350)

I predict an uptick in morgue business.


   

 

  


 
Reply 8 - Posted by: LudicrousSextus, 11/25/2012 3:34:28 PM     (No. 9033360)

Most amusing! So hospitals will now be doing their Jimmy Swaggart routine at the door? Smack ´em on the forehead, shout - "Be healed!" and hope the word ´chronic´ is removed from the dictionaries - both medical and layman versions?

Is it just me, or does the concept of ´government run health care´ have more than just a bit of oxymoron going for it? Or are they already overdosing on Oxycontin in DC?


Reply 9 - Posted by: rabbit, 11/25/2012 3:44:57 PM     (No. 9033380)

I´ve twice had to admit a senior citizen since the rule changes, and my experience has been very good. Normally hospitals push patients out too soon. In these cases, the hospital kept the patients until they felt they were stable and then provided follow-up care. The hospitals also did a better job of coordinating with the outpatient care providers instead of just presuming that very elderly patients (and their families) could do it all themselves.


Reply 10 - Posted by: snowcloud, 11/25/2012 3:49:25 PM     (No. 9033391)

#1, we shouldn´t be so sure these are "un"intended consequences. I won´t say anything more.


Reply 11 - Posted by: janylou, 11/25/2012 3:56:09 PM     (No. 9033400)

Isn´t it sick that a hospital can get into trouble refusing to provide care to anyone who comes to the emergency room, even illegals, yet are told to discharge patients even if they aren´t well enough to go home?


Reply 12 - Posted by: Grambo, 11/25/2012 4:09:02 PM     (No. 9033410)

The mistake in Viet Nam of having McNamara’s whiz kids using business school metrics (body counts) to over-rule generals and run a war, is about to live again as government gnomes dictate to doctors how to deliver health care. Hire your concierge MD while you can.


   

 



 
Reply 13 - Posted by: Teleologicus, 11/25/2012 4:18:47 PM     (No. 9033417)

This is the bureaucrat´s solution to a problem caused by bureaucrats, a reimbusement schedule that encourages, indeed requires the earliest possible discharge. Thanks to bureaucratic rules, hospitals are under extreme financial pressure to discharge patients quickly. This naturally leads to a high rate of re-admissions, since some of those discharged prematurely require re-admission. It also leads to preventable deaths, which are the best possible, i.e. least expensive outcome for bureaucrats.

Hospitals and doctors are caught between a rock and a hard place. Keep the patient too long and expenses exceed reimbursements. Discharge the patient prematurely and have to re-admit them shortly, and financial penalties are imposed.

This is the nightmare world of Medicare and insurance bureaucracy. In many cases the best and most profitable solution, the one requiring the least paperwork, is for the patient to expire immediately upon admission, as soon as the papers are signed, and before even reaching the floor.

I don´t know where the physicians and hospital administrators needed to try to make this system work are going to come from. No one with any sense would knowingly put themselves in such an impossible, lose-lose situation.

Upshot: patients who have been discharged before they were stable will now be held and treated in emergency rooms or outpatient facilities in order to avoid the financial stigma of early re-admission. Some, of course, will simply be sent home with a new prescription and will die from lack of necessary and available care.

The fantasy ideology of Leftism and the inhuman mentality of bureaucrats blind them to scenarios like this and others that are perfectly obvious and predictable to most normal adults. Nor will those responsible learn from the unintended consequences of their misguided rules and regulations.


Reply 14 - Posted by: Wendybird, 11/25/2012 7:14:33 PM     (No. 9033581)

#13 explains it perfectly. Unfortunately, he wasn´t one of the folks who designed Obamacare or Medicare. Whatever compassion physicians and nurses once had is being bred out of them in present training and residency programs. I finished residency in 1978, and see present residents and their rules daily in the present system. But not for much longer.


Reply 15 - Posted by: mabel normand, 11/25/2012 7:42:37 PM     (No. 9033611)

I predict tort reform will soon be in the works.


Reply 16 - Posted by: bubber, 11/25/2012 10:49:53 PM     (No. 9033746)

I am going through exact same thing...with my stroked out brother...hard to figure out...awful people run the government...


Reply 17 - Posted by: Trigger2, 11/26/2012 12:47:41 AM     (No. 9033801)

I predict cronic patients will be sent home and told to take a blue pill. That pill will be a cyanide pill but they won´t tell them that.


   

 

  


 
Reply 18 - Posted by: ColonialAmerican1623, 11/26/2012 1:21:55 AM     (No. 9033817)

I can foresee a time when you won´t be admitted the first time, so there won´t be a readmission problem.

What are they going to do about uncontrolled diabetic patients who are in and out of ER constantly ?



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Headline corrected.

   

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