Here where my daughter practices, nursing homes are NOT being used. Patients are sent home TOO SOON because medicare doesn’t cover long stays. Home based care does the best they can with all types of patients but some of these patients should not have been sent home....maybe not even to a SNF (which is really I think what you mean by nursing home) because there just aren’t as many of those as one would think.
We agree on the following “Overall, it will not decrease health care costs”. The ACA wasn’t designed to produce good health care at reasonable costs. It was designed to give O all the power he could possibly grab. IF he actually leaves office, it will be incumbent on the next president to deescalate (that is assuming that conservatives manage to win the WH)
Maybe not in your daughters area, but I have read articles in which hospitals are pushing their patients ( who meet inpatient acuity and have been in the hospital 3 midnights) into SNF s because it reduces their risk of a return admission. However, that only applies to the patients who meet the inpatient criteria. Medicare has made a 48 hour observation rule on all patients admitted to the hospital( in which all insurance companies now follow- if Medicare makes a rule by law that rule applies to everyone) which makes it hard for patients to meet the criteria for an SNF because If you are an observation patient, you do not qualify for an SNF. If we had Republican politicians who had an ounce of intelligence, they should be screaming this fact about Obamacare to the elderly population, but they do not.