An op-ed in the Boston Globe suggests not paying for rehospitalizations for Medicare patients within 30 days:
Medicare spends vast sums on hospital care for patients readmitted within 30 days of their previous stay in a hospital. These readmissions are often avoidable. And if Congress focuses on reducing the need for rehospitalization in areas where the practice is most common, Medicare could save many billions of dollars.
Not surprisingly, op-eds like these are written by non-physician policy makers, and further puts doctors in increasingly difficult situations.
Physicians are pressured by hospitals to discharge patients and keep the turnover high, which increases revenue for the hospital.
Now they’re taking it from the other end, with this proposal not to pay for readmissions.
It would be nice if someone advocated the proper support system be put in place first before acting on these ideas.
The major reason for readmissions is inappropriate follow-up, which can be directly traced to a lack of primary care access. Solve the primary care shortage, and readmissions will go down.
Rather than cuts in payment that only superficially addresses the problem, policy makers should be trying to embrace the true cause of many of our health system’s problems.
That means ensuring appropriate patient access to primary care.
Related posts:
- Why hospitalized Medicare patients get re-admitted so frequently
- Hospitals lose money by preventing patient re-admissions
- Using the no-pay list to control costs
- Universal health care and the physician shortage
- Did the University of Chicago sacrifice patient care for profit?
- Three midnight rule
- Op-ed: Ease ER overload
{ 3 comments }
We review readmits at the hospital department meetings. The major reason for readmission is NOT inappropriate follow up, it’s that a significant fraction of these patients are incredibly sick. Many of our Medicare admits have multiple additional problem. For example, many severe COPD patients have several admits each winter despite appropriate care and close follow up. Like DVTs and catheter related infections, these can be reduced but not eliminated.
However, since the likely goal of this is cost reduction and postponing the inevitable collapse of the Medicare Ponzi scheme, it doesn’t matter whether these are unavoidable.
yeah most of the readmits i see are that the medicare patients are very sick. End stage copd meets inpt criteria walking down the street and so they get admitted and discharged over and over.
dvts in cancer patients aren’t preventable completely, you can decrease incidence but at what cost. How many bleeds will you have because you over anticoagulated someone.
If this comes to pass then it just might be better to kill these sick old people rather than discharge them. Or never admit them. Just through them out of the ER and let them die where they fall.
Comments on this entry are closed.