Medicare holds all the cards here. It is true I get to designate a patient inpatient or observation. BUT - if I guess wrong according to medicare rules they will not pay for the hospitalization. And they can come back many years later through something called a RAC audit and decide the patient was inappropriately classified and demand money back from the hospital
I practice full time hospital medicine, I see only hospitalized patients. Coding and admission status take up most of my time and energy, not only do I have to guess right, but I have to document adequately in the chart to back it up. Hospital case managers also weigh in on admission status. Its a giant scam by which Medicare tries not to pay for care. Once you get the rules down and become proficient at guessing what they want, they change the rules sometimes with little to no notice.
Of course Obama care will solve all these problems and I can ride my unicorn home after work.....
Thanks for your input from a medical doctor’s perspective. I find it interesting and I’m sure others will also.
I didn’t know a unicorn came with obamacare. That sly devil! Accent on the DEVIL!!!!! Does it come with food and a stall? Is it a current model in good shape?
The stress among the patient population is high. I can’t imagine what it’s like for caregivers of all kinds.
My husband was admitted to the hospital in October after 4 1/2 hours in the ER. I had never heard of this situation before but believe me, I will be on the lookout for it in the future. He’s had 2 hospitalizations in the past 5 years with breathing problems (COPD) and probably not the kind of situation that would call for a nursing home or rehabilitation but I will fight the politicians for everyone. My job at this age is to take care of him, and let the DC politicians know what I think of them.