The Health Administration Should Be Paid For The Medical Bills

This is an opportunity for hospitals to work more closely with skilled nursing facilities and other post-acute providers to improve care transitions, and experience fewer readmissions. The ACA impacted hospitals by holding back a one percent reimbursement rate. Hospitals will actually need to perform and deliver high-quality evidenced based care to recover the one percent withheld reimbursement rate while hospitals that exceed the benchmark, will received a higher reimbursement rate over the one percent. The Act is intended to help spur the trend of more integrated care throughout the continuum. The Affordable care act (ACA) of 2010 designed programs for improvements and innovation in the quality of hospital care by instituting the Medicare’s hospital readmission reduction program. Through this program, CMS reduces Medicare payment bt one percent for hospitals for hospitals that demonstrated high rate of avoidable readmissions for patients with a diagnosis of heart failure, heart attack

The overall process of discharging a patient from a hospital and the transition back home or to a care facility are critical advancements in the overall course of both acute and long-term care. It is important that the hospitals releasing these patients have ensured the proper overall course of care from beginning to end. The lack of consistency with both the discharge process and the quality of discharge planning has led to many avoidable readmissions. To reduce the amount of hospital readmissions, it is imperative that hospitals recognize the need for focused patient care and that programs are being implemented to assist in the care transition.

After working under these horrendous conditions, including lack of sleep, lack of electricity to keep the newest technology machines working, shut-down elevators and air conditioning, and an unsanitary working environment, the remaining staff members at Memorial did what they could. The reason and quantity of the medications that were found in patients’ bodies were unquestionably incorrect with the justification by Dr. Pou that she was simply trying to reduce their physical suffering and relieve their anxiety. In this case, Dr. Pou’s situation was considered malpractice, because people argued that there were other ways to help these patients. Rodney Scott, one of the last patients to leave the hospital stated, “How can you say euthanasia is better than evacuation?..If they had vital signs, then get ‘em out. Let God make that decision,” (Fink, 28). It is anticipated that nurses will experience challenging working conditions, including an environment of fear, and too much responsibilities or things to focus on. To prevent faster burnout and secondary trauma, nurses will need sufficient rest periods, emotional support especially from the hospital facilities and

The movie fire escape emphasizes that America has the most expensive health care system in the world but is not one of the best in regards to healthcare outcomes and life expectancy. It spends more than what the whole world all together spends on pharmaceutical industry. 75% of the 2.7 trillion dollars were spent on treating preventable diseases which indicate that US health care is more focused towards disease management than prevention. The movie makes a point that there are frequent readmissions and 80% of health care budget goes towards these 20% patients who are frequently readmitted to the hospital due to an existing chronic condition. Health care professionals are paid on the basis of number of procedures carried out on the patient rather than their health outcome. So the focus is not on curing the disease by eliminating the risk factors but merely managing the disease and looking for quick fixes. That is how patients want it too. They want to be cured right away with a pill or surgery but are not really interested in learning the long term solutions and preventative measures.

Readmission to a hospital creates strain and added expense for the patient and hospital; in 2011, hospital costs due to readmission were almost $41.3 billion (Hines, Barrett, Jiang, & Steiner, 2014; Rau, 2014). There are many aspects of healthcare associated with readmission, such as lack of discharge planning and education, which need to be addressed i to decrease the amount of preventable re-hospitalizations.

This model reimburses hospitals based on quality of care instead of the volume of patients. The quality of care is assessed by patient questionnaires and if hospitals are unsatisfactory penalties may be imposed (Edwoldt, 2012). The value-based system also affects Medicare and Medicaid. It was reported that Medicare readmissions within 30 days of discharge cost 17 billion dollars annually (Edwoldt, 2012). Due to the high costs of readmissions Medicare and Medicaid have implemented a Hospital Readmission Reduction program. A formula is utilized to evaluate readmission rates within 30 days of discharge for any medical reason related to their original admission such as heart failure and pneumonia. Upon review the hospital is potentially penalized. It is important that nurses strive to provide excellence in care despite their beliefs on the ACA. Nurses have the ability to provide a safe patient environment and reduce the risk of hospital associated infections by following hospital protocols such as hand washing.

In some cases I can see where releasing one from the hospital could be somewhat beneficial for the patient, than it would be to stay and receive care there. If you think about it there are so many chances of infection setting in. Hospitals are full of sick people and germs are carried in and out of the doors regularly. I am aware that the homes of the patients are germ infested as well, but those germs are familiar germs that the person body more and likely has already developed immunity to. It may be better in some cases also for the person to be released because of the noise making it uncomfortable for people recover peacefully. It also may have nothing to do with the doctor’s decision to discharge the patient, but the patient’s insurance company. Insurance companies only give a specific number of days of stay for specific illnesses. If you want to stay longer because you still feel ill, you may have to pay for days they don't authorize. Insurance companies don't look at the patient; they look at the diagnosis only. It's a business decision, often not a medical one.

In 2013 an average of one out of eight Medicare patients are readmitted within a 30-day period which lead to the estimated costs of around $18 billion a year for Medicare patients alone. Hospitals will either be penalized or receive bonuses for their performance with readmissions. This program will encourage hospitals to concentrate on ways to improve coordinating transitions of care while improving the safety and quality of care provided. In order to

Patients and given sub optimal care, are discharged prematurely, and end up getting readmitted due to not initially receiving the proper care.

Your hospital will be penalized if you get readmitted within 30 days because of the chronic disease mismanagement. The Affordable care act (ACA) has changed the perspective of chronic disease management of hospitals, shifting their focus from treating the conditions to deciding ways to prevent them. Under ACA, hospitals will be penalized or rewarded depending upon their performance on 30-day readmissions, infection control and patient satisfaction levels (1). Government is playing his role to reduce the burden of chronic diseases in society but being a responsible citizen, do we realize the intensity of situation and the economic instability it is causing?

I have always wondered that why the medical cost in United States is outrageously expensive as simple diagnosis of a symptom from the doctor would cost ten times more in United States than Korea. Furthermore, if people are already paying large amount of money for these healthcare services it is natural to ask if we are receiving the finest care in the world.

The State of Washington has applied these rules to their Medicaid population with the caveat that the readmission would be considered an avoidable readmission if it fell within 14 days of the previous stay at the safe or affiliated hospital (Payment Limits - Inpatient Hospital Services, 2011). These rulings detrimentally affect hospitals with high readmission rates among the Medicaid cohort and the actual readmission for the patient puts them at increased risk for infection and injury. The Robert Wood Johnson Foundation’s report on this conundrum (2013), notes that one in eight Medicare patients will readmit within 30 days of a previous hospital discharge; the reasons include the patient not being able to find their discharge paperwork, not understanding their discharge paperwork, and poor discharge planning. Working to resolve these issues could therefore decrease avoidable readmissions.

Policy makers created the Medicare Hospital Readmissions Reduction Program (HRRP) in an attempt to improve quality of patient care and lower costs (James, 2013). In order to avoid these penalties, healthcare leaders must recognize that CMS has identified a correlation between readmissions and a lack of quality care. Therefore, the aim is not to focus solely on hospital readmissions, but to seek clinical excellence by investing in quality improvement (Silow-Carrol, Edwards & Lashbrook, 2011). However, reducing readmissions is a complex undertaking, because not all readmissions can or should be prevented. Indeed, some readmissions are planned as part of sound clinical care. Furthermore, while hospitals work to reduce readmissions caused

For years, healthcare costs have continued to increase in the United States and policymakers are constantly trying to find ways to reduce spending. According to reports, in 2011, about $900 billion out of the $2.6 trillion annual health care spending was wasteful spending. In the following year, there was a reported $690 billion wasted annually on healthcare. This wasteful spending is attributed to ineffective health care delivery, cost of adverse events, and poor care coordination that has led to avoidable readmissions (Lallemand, 2012). In the United States, readmissions are the highest amongst patients with chronic diseases accounting for about 90% of avoidable readmissions in 30 days after discharge, and costing the industry an estimated $17 billion. These readmissions are a result of inadequate discharge planning, lack of follow-up, and lack of education on disease management (Jayakody et al., 2016). Policymakers on the federal and state level have developed and implemented several programs, some varying state to state, to help reduce wasteful spending while improving quality of care.

Obermeyer, Ziad, et al. "Early Death After Discharge from Emergency Departments: Analysis of National US Insurance Claims Data." BMJ : British Medical Journal (Online), vol. 356, 2017. Research Library. Ziad Obermeyer conducted a study showing the number of deaths after being released from a hospital. Obermeyer's study was on Medicare patients from 2007-12. He conducted his research on healthy looking people living in the community. The ones he excluded from his experiment were patients that were having to stay in a nursing home and/or being given hospice care. Once they are released from a hospital generally healthy, some of them die seven days later, some sooner and some later. Obermeyer then studies their death certificates and determines