25 July 2013

Hospitals Are Even More Greedy Now

I dislike saying this, but I read so much lately about the monopolistic and greedy actions by hospitals that I must express my feelings. Hospitals are under pressure from the Center for Medicare and Medicaid Services (CMS). Instead of working to become more efficient in medical care, give proper discharge instructions, eliminate unnecessary tests and procedures, and reduce readmissions, many are making no changes, or actually doing more tests.

Instead, hospitals are cutting staff, reducing work hours where they can to eliminate paying for medical insurance and other benefits, and they are increasing tests and billing at an ever-increasing rate. Hospital administrators are increasing their salaries and when possible their bonuses. Hospital boards are not enforcing efficiencies, patient safety, and are looking the other way when it is convenient. Even hypothesizing like this blog won't do any good, as the hospitals do not want to work for efficiencies.

Hospitals are now gaming the system and working with ambulance companies to transfer patients that would be readmissions to a neighboring hospital. How far will this go before CMS realizes this is happening? The ambulance drivers know how far it is to the different hospitals and will contact one hospital and ask if this is a readmission and do they want the patient taken to another hospital that is only a few miles further. The hospital says the emergency room (ER) can't handle another patient so that the ambulance company can legitimately take the patient to a further hospital. If the patient is beyond the 30 days or not a readmission, they say they have room in the ER. You can be assured there is a payment being made to the ambulance company.

The other game that hospitals have played for years, but will become more common will be admitting the patient as an outpatient or for observation instead of admitting the patient as an in-patient. This means that the full bill will fall to the patient because insurance does not cover hospitalization as an outpatient. This will add stress and often cause the patient to file bankruptcy.

Will hospitals learn from their mistakes? A few will, but most are profit crazy and have an attitude of milk the cow as long as they can. When the cow dries up, find another cow to milk is the attitude of many hospitals. That is why they have cut so many employees and are running on short staffs, as this is the way they cut costs rather than look for places they can become more efficient and eliminate costs.

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