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Hospitalization of Medicare Beneficiaries in Long-Term Care Costs Program Billions

October 14, 2010
by root
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The 1.7 million Medicare beneficiaries who resided in long-term care facilities during 2006 cost the program $25 billion, with nearly 40% of that cost going toward hospitalization expenses, according to three new reports released by the Kaiser Family Foundation.

“The findings suggest policymakers looking to trim Medicare expenditures in accordance with the new federal health care law may want to take a closer look at developing a more coordinated system of care for this narrow subset of the Medicare population,” Kaiser Health News reported.

By cutting the number of hospital stays of beneficiaries in long-term care by 25%, Medicare would save at least $2.1 billion this year alone, according to the reports. Savings to Medicaid would most likely result as well.

Among the reports’ explanations for unnecessary hospitalization occurrences in this subset of beneficiaries, a deficiency in qualified staff and physicians who prefer inpatient treatment due to convenience are blamed.

Read more

Studies Highlight High Medicare Costs For People In Nursing Homes

Briefing Examines High Medicare Spending for Beneficiaries in Long-Term Care (downloadable reports)



Multiple studies have been done on the potential harm to residents of LTC who are sent to the hospital. Many times, the disease process can be handled at the facility with less cost and less disruption to the resident. Perhaps a bit more reimbursement to LTCs and SNFs would allow more staff training. Older people, especially those near the end of life, are much better taken care of with people who know them and care about them.

As someone that has been hospitlized, we need to examine hospitalists as part of the problem. They may provide excellent care, but they create considerable discharge issues: have yet to have one contact my primary physician regarding medications coordinate information given to me with my primary physician and/or surgeon follow-up with me post discharge (two discharges). I have had to provide my primary physician with information regarding comments and/or medication recommendations made by the hospitalistsnot the physicians themselves. There are to many physicians becoming involvedthe primary making the referral to the surgeon, the surgeon who doesn't provide anything but the surgical care, and the hospitalist. Have tried to refuse the care of the hospitalist during both surgies but have been told it is "hospital policy". What a racket for causing increased costs and decrease consistency in care.

As a nursing home administrator it is frustrating to watch our residents be shuffled to and from hospitals for what are relatively minor issues, which usually not better when they return. Nursing homes are treating increasing more complex and technical issues.
We should be reimbursed accordingly, staff accordingly, and receive appropriate credibility from regulators.
Your Kaiser Foundation articles are on the money. I forwarded it to my Medical Director.