Jul 13 2010
Bloomberg Businessweek: "Elderly patients caught between U.S. hospitals and Medicare auditors pushing to cut costs are increasingly facing tens of thousands of dollars in unexpected medical bills. ... The observation classification [in medical billing] is designed to be used when there isn't an immediate diagnosis, or if it is determined the condition isn't normally treated within an inpatient setting, such as setting broken bones. … Hospitals, though, sometimes extend the use of observation status to avoid being challenged by Medicare auditors on patient admissions when cases fall in a gray area between inpatient and outpatient. Inpatients are more costly to Medicare, said Robert Corrato of Executive Health Resources, a consultant for hospitals on how to classify patients. Medicare watches admissions closely, and if an admission is ruled inappropriate, the hospital doesn't get paid. … Medicare has begun looking into how hospitals use the observation classification" (Armstrong, 7/12).
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. |