Meet SEC. 1151 of ObamaCare. Its innocuous title is Reducing Potentially Preventable Hospital Readmissions. Its reality is that it exists to keep elderly Medicare patients from being readmitted to hospitals by forcing hospitals to reduce such readmissions.
Here’s the grim reality of SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS from a physician on the ground.
Today while working my shift in the emergency room, an old lady was brought in very sick and in fact near death. I did my usual workup and evaluation and attempted to administer life saving treatment. It was my plan to admit this woman to the hospital. I found out a little later that this same woman had been a patient here just slightly more than 2 weeks ago with a DIFFERENT DIAGNOSIS. I was told that if this woman was admitted, the hospital would not be paid.
The new Medicare rule now is that if the same Medicare patient is re-admitted to the hospital within 30 days, the hospital will not be paid. When they first started this nonsense they said this only applied to patients with the same diagnosis. Now they have “expanded” the rule to include re-admissions for any reason. So if you’re in the hospital for pneumonia, and 3 weeks later, you break your leg…….too bad. Medicare will not pay the hospital to fix your leg.
A little later a man was brought in by ambulance, very sick, in pain, and near death. I did my usual evaluation and treatment, doing my best to ease pain and stabilize this man’s illness. He needed to be admitted. To my chagrin I found out that he had been treated for the SAME problem at a DIFFERENT HOSPITAL about 10 days prior. If I admitted this man, our hospital would be paid nothing. I admitted the man.
This doctor made the ethical decision, but as the penalties keep adding up, hospitals will either take the decision away from doctors and turn it over to bureaucrats or they will shut down emergency rooms to avoid the penalties. Either way Medicare patients will die and the “ethicists” behind ObamaCare will take another vacation in the Alps, congratulating themselves for keeping down costs.
As many as a quarter of heart attack patients are readmitted within 30 days. And those hardest hit will be Low Income African-Americans
The penalties will fall heaviest on hospitals in New Jersey, New York, the District of Columbia, Arkansas, Kentucky, Mississippi, Illinois and Massachusetts, a Kaiser Health News analysis of the records shows.
The analysis of the penalties shows that 80 percent of the hospitals that have a lot of low-income patients will lose Medicare funds in the fiscal year starting in October. Sixty-seven percent of the hospitals treating few poor patients are going to be penalized, the analysis shows.
Studies have found that African-Americans are more likely to be readmitted than other patients, leading some experts to be concerned that hospitals that treat many blacks will end up being unfairly punished.
Atul Grover, chief public policy officer for the Association of American Medical Colleges, called Medicare’s new penalties “a total disregard for underserved patients and the hospitals that care for them.” Blair Childs, an executive at the Premier healthcare alliance of hospitals, said: “It’s really ironic that you penalize the hospitals that need the funds to manage a particularly difficult population.”
But that’s okay, because those hospitals will either shut down or close their ER’s. African-Americans with heart attacks will not be readmitted because they will have as much trouble finding a qualified hospitals, as finding a supermarket in Detroit.
On average, the readmissions penalties were lightest on hospitals in Utah, South Dakota, Vermont, Wyoming and Oregon, the analysis shows. Idaho was the only state where Medicare did not penalize any hospital.
What do those states have in common? Low minority and African-American populations.
But the damage of ObamaCare extends beyond shutting down hospitals and ER’s that serve minority areas. They are damaging the elderly in general.
Hospitals are run by people who are expert in making sure they get paid. ObamaCare squeezes hospitals. Hospitals squeeze patients.
Jean Arnau spent five days in the hospital with a fractured spine — lying in a hospital bed, wearing a hospital gown and ID bracelet, eating hospital food and receiving regular nursing care.
But when she was discharged and needed to transfer to a skilled nursing facility for rehabilitation, her family learned that she had never been formally admitted as an inpatient to the hospital at all. Instead, she’d been classified as an outpatient under “observation” — a status that would cost her thousands of dollars.
Under the rules, Medicare picks up the whole tab for the first 20 days in an approved skilled nursing facility for rehab or other care, but only if someone has spent at least three full days in the hospital as an admitted patient. If instead a patient has been under observation — for all or part of that time — he or she is responsible for the entire cost of rehab.
So hospital admits patient under “Observation”, saving their life and dodging the ObamaCare penalty, but passing the buck on to the rehab facility. The rehab facility can’t get paid and hits the patient with a whopping bill. So the problem has moved down to another level. At the end of the chain, it’s always the patient who gets screwed, one way or another.