Timing Discharges to Maximize Revenue - "Corruption" of Corporate Long-Term Hospitals?

A recent Wall Street Journal article that focused on a quirk in US Medicare payment rules that may be gamed by long-term hospitals also revealed the plight of physicians employed by such hospitals, and worse, the danger posed by such gaming to patients.Discharging Patients at Particular Times Maximizes Hospital RevenueHere is how the rule works: Under Medicare rules, long-term acute-care hospitals like Kindred’s typically receive smaller payments for what is considered a short stay, until a patient hits a threshold. After that threshold, payment jumps to a lump sum meant to cover the full course of long-term treatment.That leaves a narrow window of maximum profitability in caring for patients at the nation’s about 435 long-term hospitals, which specialize in treating people with serious conditions who require prolonged care.Systemic Evidence that Discharges are More Likely to Occur at Times that Maximize RevenueThus the Medicare rules provides financial incentives for discharging patients at particular times during their admissions. The reporters found some systemic evidence that patients were more likely to be discharged at those times:The Journal analysis of claims Medicare paid from 2008 through 2013 found long-term hospitals discharged 25% of patients during the three days after crossing thresholds for higher, lump-sum payments. That is five times as many patients as were released the three days before the thresholds.The issue here is that the decision to discharge a...
Source: Health Care Renewal - Category: Health Management Tags: corporate physician health care corruption Kindred Health mission-hostile management Select Medical Source Type: blogs