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Follow up care is good,but It will be an added expense,who will pay??
You think the hospital will eat the additional costs?
The way hospitals are being paid is starting to change. The model in which hospitals generate revenue off an endless stream of widgets (including unnecessary and preventable readmissions) is in the preliminary stages of shifting toward models that reward them for doing a better job. That means when they provide the supports vulnerable folks need immediately after discharge, to prevent them from winding right back up in the hospital, they'll do better financially. As opposed to the current model, in which the hospital does better financially if that person ends up back in the hospital a week later. See the examples of what some hospitals are doing to deal with these financial penalties I've already posted above, e.g. using nurse practitioners placements to make sure folks weather the discharge well.
It's actually exactly in line with part of the MedPAC recommendation I just quoted:
The Commission recommends that this payment change be made in tandem with a previously recommended change in law (often referred to as gainsharing or shared accountability) to allow hospitals and physicians to share in the savings that result from re-engineering inefficient care processes during the episode of care.
These things are meant to work together precisely because they reflect a new approach to health care delivery that actually focuses on the quality of care the patient gets.
a recent Doctor Patient Medical Association poll found that 74% of doctors say they will stop accepting Medicare patients or will leave Medicare entirely because of Obamacare
And that won't actually happen either.
a recent Doctor Patient Medical Association poll found that 74% of doctors say they will stop accepting Medicare patients or will leave Medicare entirely because of Obamacare
And that won't actually happen either.
Why? Are doctors going to be forced to do what government wants? Medicare is already a mess and it will get worse. Obama isn't saving Medicare like he claims.
Of course they will refuse to readmit patients. They are fined no matter what the reason. If someone is wise, they just won't go back to the hospital where they got their treatment. Go to a different hospital.
ah yes....the "new approach to health care delivery".......code words for socialized medicine....
Obamacare IS going to change the hospital-doctor-patient model......doctors and hospitals will be forced to start to working in groups like former HMOs.....remember how crappy those were?
and now fine hospitals for arbitary reasons? Quality of care has nothing to do with it. Patients that drain resources because a hospital is forced to keep them because the patient can't be trusted with follow up care just won't survive the hospital stay. It is putting a decision to the hospitals of releasing the patient and risking a fine, keeping a patient in the hospital to occupy a bed or not having the patient at all.
There are many ways of resolving this problem, not one of them good for the patient.
Let's see...first, reduce significantly what doctors will get paid under medicare, then gut $780 mil from medicare, but say it's OK because they will make up the savings in - try saying it with a straight face - reducing waste,
You make a good point - but for those people who cannot be trusted with their own follow up care - why should the hospital care about that? If someone ignores the advice of a hospital and makes themselves sick again, I think the hospital - any hospital - should be able to refuse to admit them.
Penalizing high rates of readmissions encourages providers to do the kinds of things that lead to good care, but are not reliably done now. For example, the kinds of strategies that appear to reduce avoidable readmissions include preventing adverse events during the admission, reviewing each patient’s medications at discharge for appropriateness, and communicating more clearly with beneficiaries about their self-care at discharge. In addition, hospitals, working with physicians, can better communicate with providers caring for patients after discharge and help facilitate patients’ follow-up care.
Doctors are required by federal law to provide patients with a copy of their medical notes upon request, but few patients ask and doctors generally don’t make the process easy.
When patients were offered online access, however, 90 percent read their doctors’ notes with some impressive results.
A study published in the most recent issue of the Annals of Internal Medicine found that 60 to 78 percent of patients who read their visit notes reported that they were more likely to take their medications as prescribed. And their doctors reported that sharing their notes actually strengthened relationships with patients.
Study authors Tom Delbanco and Jan Walker of Beth Israel said they were surprised and delighted to find that patients who viewed their medical notes were more likely to take their medicines correctly. “Medication adherence is one of the greatest problems in health care,” said Delbanco, “yet flipping this switch seems to activate patients.”
Quality of care has nothing to do with it. Patients that drain resources because a hospital is forced to keep them because the patient can't be trusted with follow up care just won't survive the hospital stay. It is putting a decision to the hospitals of releasing the patient and risking a fine, keeping a patient in the hospital to occupy a bed or not having the patient at all.
There are many ways of resolving this problem, not one of them good for the patient.
You make a good point - but for those people who cannot be trusted with their own follow up care - why should the hospital care about that? If someone ignores the advice of a hospital and makes themselves sick again, I think the hospital - any hospital - should be able to refuse to admit them.
People only get readmitted because they were not properly treated in the first place. Perhaps this will force hospitals to treat their patients, instead of sending them off with a pack of painkillers.
People also get readmitted because they get worse. They just get worse. They have a knee replacement that's working fine and then malfunctions. They are treated for a stroke, and then have another stroke. This law is designed to prevent sick people from getting medical care. There's no real way around it. Noomi said it correctly, the people should just be denied care until they die in the hospital doorway. This is what the democrat goal is. Deaths, otherwise preventable, is the fastest way to reducing medical costs.
People also get readmitted because they get worse. They just get worse. They have a knee replacement that's working fine and then malfunctions. They are treated for a stroke, and then have another stroke. This law is designed to prevent sick people from getting medical care. There's no real way around it. Noomi said it correctly, the people should just be denied care until they die in the hospital doorway. This is what the democrat goal is. Deaths, otherwise preventable, is the fastest way to reducing medical costs.
Some readmissions are preventable and those are what this seems to be addressing.
People also get readmitted because they get worse. They just get worse. They have a knee replacement that's working fine and then malfunctions. They are treated for a stroke, and then have another stroke. This law is designed to prevent sick people from getting medical care. There's no real way around it. Noomi said it correctly, the people should just be denied care until they die in the hospital doorway. This is what the democrat goal is. Deaths, otherwise preventable, is the fastest way to reducing medical costs.
Some readmissions are preventable and those are what this seems to be addressing.
They seem to be addressing all readmissions. Which is the nature of regulation vs law. We can hold hospitals accountable for irresponsible behavior without blanket laws like this - which always have unintended consequences.
