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Started By
Message
re: Medicare pays hospitals $13,000 per COVID patient - $39,000 if on ventilator
Posted on 4/9/20 at 8:09 am to Buckeye Jeaux
Posted on 4/9/20 at 8:09 am to Buckeye Jeaux
quote:
Dr. Scott Jensen (on Laura Ingraham last night) said Medicare pays hospitals $13,000 per COVID patient - $39,000 if on ventilator.
So are hospitals getting these funds if the diagnosis is based on an assumption? If it is merely on assumption, then the abuses could easily get into the high hundreds of millions - if not into the billions.
No wonder there are so many empty beds on the ships, Javitts Center, and all other temporary hospitals.
Dr. Jensen's interview begins at 18:35
It is not based on an assumption. We have to code these patients like we code everyone else. And our Payers reimburse just like with other patients, subject to the same audits as other patients.
Anyway $13K per COVID admission assuming that the right number is for inpatient, not just a patient who tests positive. That's not terribly high given the complexity for such a patient. Or are you suggesting that we are admitting patients who don't need to be admitted?
If we get only $39K for patients who are ventilator, which I don't know to be true, then we lose a ton on that exchange since patients who are vents are necessarily in the ICU. Do you have any idea what the resource consumption for a patient who stays in the ICU for 10 days or longer like these vented COVID patients?
If hospitals really just cared about making money, we'd kick out all these COVID patients and start cranking out knee replacements and stents which pay more than what you're saying we get for COVID inpatients and those folks actually churn.
1
Posted on 4/9/20 at 8:09 am to Buckeye Jeaux
I and others have been saying this since it started, the vents are an ATM.
Posted on 4/9/20 at 8:09 am to Diamondawg
quote:
Are you familiar with the consequences of Medicare fraud?
Yep. And that’s not what I’m claiming they’re doing.
Posted on 4/9/20 at 8:09 am to Diamondawg
quote:
Are you familiar with the consequences of Medicare fraud?
Big fines and federal prison. The power wheelchair scandal back about 10 years ago, comes to mind.
Posted on 4/9/20 at 8:10 am to League Champs
quote:
It's word for word in the published guidelines: "in lieu of a positive result, it is permissible to ASSUME corona when assigning codes on the death certificate"
Do you know what a medical assumption is and how often they are used?
Posted on 4/9/20 at 8:10 am to Golfer
quote:Not being rude, but the general public is so out of the loop on how hospital reimbursement/coding works
That’s the point. The fedgov has added additional compensation for COVID claims. Hospitals are incentivized to pad those numbers,
Posted on 4/9/20 at 8:11 am to lsupride87
quote:
We are getting buttraped financially because of this
And they are doing everything they can (including over reporting corona) to make up for it.
Family member has been hospitalized twice during the lock down for a fib. Kept 5 days each visit, and now referred to in-house rehab. Padding those charges.
Posted on 4/9/20 at 8:12 am to GeauxFightingTigers1
quote:
I and others have been saying this since it started, the vents are an ATM.
This is literally the opposite of the truth. It's like a reverse ATM. For a decade or so pushing mechanically ventilated patients out of acute care settings has been one of the most pressing joint goals for payers and delivery systems alike because everyone loses money on these patients.
Posted on 4/9/20 at 8:12 am to League Champs
quote:
And they are doing everything they can (including over reporting corona) to make up for it.
Family member has been hospitalized twice during the lock down for a fib. Kept 5 days each visit, and now referred to in-house rehab. Padding those charges.
The last thing we want is a covid patient. We are losing are asses on them because they are inpatient for so long
This post was edited on 4/9/20 at 8:13 am
Posted on 4/9/20 at 8:12 am to gthog61
quote:
cha ching
I think you mean Bada Bing
Posted on 4/9/20 at 8:13 am to lsupride87
quote:
Not being rude, but the general public is so out of the loop on how hospital reimbursement/coding works
Agreed.
That’s nothing to do with my post, though.
Posted on 4/9/20 at 8:13 am to League Champs
quote:
Family member has been hospitalized twice during the lock down for a fib. Kept 5 days each visit, and now referred to in-house rehab. Padding those charges.
You do understand that the hospital will receive next to nothing for that second admit, right?
Posted on 4/9/20 at 8:13 am to longwayfromLA
quote:
This is literally the opposite of the truth. It's like a reverse ATM. For a decade or so pushing mechanically ventilated patients out of acute care settings has been one of the most pressing joint goals for payers and delivery systems alike because everyone loses money on these patients.
Right, yet, we've known since February that the vents are useless for this thing yet, they pushed for vents. Right now its the only money the hospitals are making.
This post was edited on 4/9/20 at 8:14 am
Posted on 4/9/20 at 8:14 am to Golfer
quote:"padding their numbers" is not fraud? OK den!
And that’s not what I’m claiming they’re doing.
Posted on 4/9/20 at 8:15 am to lsupride87
quote:
We are getting buttraped financially because of this
Surgical centers and hospitals in rural areas without large national backing may never recover
Posted on 4/9/20 at 8:16 am to QboveTopSecret
quote:
Some of that video was cut out youtube censors this one has it all.
YT
start at 54 minute mark.
Thanks. Put it in the OP - and some very important info starting at about 53:07
Posted on 4/9/20 at 8:16 am to Golfer
quote:Yes, it does
That’s nothing to do with my post, though.
Unless you assume the random nurses, doctors, and coders who arent incentivised at all with reimbursement rates are cooking the books.
Or are you insinuating hospital admin is going into charts and committing extreme fraud?
Posted on 4/9/20 at 8:17 am to lsupride87
quote:
We are getting buttraped financially because of this
All the more reason to cook the Covid numbers for some guaranteed money.
Posted on 4/9/20 at 8:17 am to GeauxFightingTigers1
quote:
Right, yet, we've known since February that the vents are useless for this thing yet, they pushed for vents. Right now its the only money the hospitals are making
We lose our arse once they go on a vent and become patients for weeks on end in the inpatient setting
Best case scenario for us is they come in, and we are able to push some meds and get the out quickly
Posted on 4/9/20 at 8:18 am to GeauxFightingTigers1
quote:
Right, yet, we've known since February that the vents are useless for this thing yet, they pushed for vents.
I'm not sure who "we" is in this scenario, but as a non-clinician, I am out of my area of expertise. Generally speaking, patients who go on mechanical ventilation for any reason have dire chances in terms of good outcomes, this seems true as well of COVID -19 patients. We still treat COVID patients with ventilators because it does have positive impacts on percentage of the patients. That is how critical care medicine works.
But none of that is my point. To use vents or not is a medical question above my pay grade. It is squarely within my expertise to tell you that ventilated patients are not lucrative to health systems.
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