Medicare: More Patients Being Kept for Observation

    June 5, 2012
    WebProNews Staff
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Medicare patients are being kept for observation at hospitals more often than they’re being admitted, thanks to pressure from the federal government. According to a recent study, the number of individuals who have been kept for observation has risen dramatically over the past several years. And while the decision not to admit those on Medicare may help cut costs down the road, the end result, unfortunately, is more out-of-pocket costs at the expense of the patients.

Researchers at Brown University in Providence, Rhode Island poured over nearly 29 million records from Medicare beneficiaries to analyze the data, which yielded some interesting statistics. In 2009, patients recommended for observation numbered in the millions. However, in 2007, only around 815,000 individuals weren’t immediately admitted. In turn, the number of admissions feel sharply during the same time frame, indicating that doctors are being a bit more careful about who they admit and who they decide to observe.

Here’s the problem with this setup: Those who are admitted to hospitals often pay a lot less than those who are kept for observation. Since these individuals are classified as “outpatient” per Medicare rules, their co-payments are often considerably higher. Additionally, these individuals may be turned down for subsequent care in nursing facilities should they require it.

“The dual trends of increasing hospital observation services and declining inpatient admissions suggest that hospitals and physicians may be substituting observation services for inpatient admissions — perhaps to avoid unfavorable Medicare audits targeting hospital admissions,” study author Zhanlian Feng said in a Brown University press release.

  • Melinda Massey

    I can so relate to this. My mother became very ill, lethargic and could not walk, dress herself etc. My mother almost passed away because doctors at two different hospitals would not admit her. One agreed to keep her for “observation” after I pitched a fit and pleaded my case to the hospital’s upper management. I wasn’t leaving till they listened. But, they released her the next day. The very next day she became so ill she couldn’t speak. We called an ambulance and requested a hospital 35 miles away. They admitted her immediately. She had a terrible UTI, was dehydrated etc. She stayed in the hospital for a couple of weeks and was told she would never walk again. We made a family decision to admit her to a nursing facility. She was evaluated and a very clever doctor found out that a med she was on for Dementia w/hallucinations, had caused some severe side effects and nearly destroyed her. She is better now but the fight we had to endure with the doctors, ER’s and hospital staff was incredible. It only took one doc just a day or so to figure out what was wrong. Tell me who paid the bigger price? And not just monetary!

  • http://www.familyhomecare.org Paula

    It is sad that the patient’s welfare is not being taken into consideration. I again remember the John Q movie because of your story! When will they learn.

  • http://www.medicarerhodeisland.com/ Medicare Rhode Island

    Very sad to know the patients situations…. Federal government have to take some actions regarding this issue.