Even More Obamacare Follies

Here is one of many.....read it and give us a summary.,..it was just the first one I saw

Rural hospitals in critical condition


That was clear as mud. And if anything it blames closures primarily on the fact that the GOP-controlled states opted out of the Medicaid expansion to scroe cheap political points, which is costing those hospitals revenue.

The only sentence I could find in there that actually links any problem to the ACA was this one --

"Hospital officials contend that the law's penalties for having to re-admit patients soon after they're released are impossible to avoid and create a crushing burden."

I've read that ten times and am still trying to figure out what it means. The penalty for having to readmit? WTF is this person talking about?

Anyway, the real problem for these hospitals is that the GOP governors of their states wanted to be able to say they didn't go along with the ACA. A lot of them are relenting, as the hospitals in those states are figuring out how much money they are leaving on the table.
 
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"Hospital officials contend that the law's penalties for having to re-admit patients soon after they're released are impossible to avoid and create a crushing burden."

Not sure if it applies universally, but there are previsions where the government won't pay for patients to get re-admitted (within X days) to treat conditions they were just hospitalized for.

So the hospital can't bill to treat Y, discharge the patient, then repeat the cycle three days later. Economic incentive to treat it sufficiently the first time.

Not sure why that would effect a rural hospital any more than an urban one.
 
Not sure if it applies universally, but there are previsions where the government won't pay for patients to get re-admitted (within X days) to treat conditions they were just hospitalized for.

So the hospital can't bill to treat Y, discharge the patient, then repeat the cycle three days later. Economic incentive to treat it sufficiently the first time.

Not sure why that would effect a rural hospital any more than an urban one.

To add to this a bit. The penalties come in the form of lowered reimbursement for Medicare/Medicaid.

So as the patient payer mix shifts more towards M or M then the hospital suffers more if they have readmissions.

Why do they have readmissions? Well many patients have co-morbidities (diabetes but are admitted for a cardiovascular problem). The readmission penalties can hit even if the readmission is not part of the original admission problem.

Why rural hospitals?

1. To the extent their payer mix is a higher proportion of MM to private insurance they feel the effect more.
2. Rural hospitals are general service but not destination for higher reimbursing service lines like cancer treatment, cardiovascular (bypass, etc.), OBGYN specialties, etc. Basically they don't have the ability to draw better paying patients to subsidize the worse paying (Medicare/Medicaid) so they face difficult financial pictures and combined with #1 they are more vulnerable to reductions in reimbursement rates.
 
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More on why rural hospitals

Another concern about the program is that safety-net hospitals that treat large numbers of low-income patients have been more likely to receive penalties, in part because poor patients face financial and logistical challenges that make them more likely to get sicker after discharge than others, even if the hospital is trying to oversee their recuperations.

The lower the number of HC resources in your area the less likely you can seek preventive and follow-up care and more likely to return to the hospital (the only one around).

Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties | Kaiser Health News
 
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Extending deadlines for whatever reason and throwing out subsidies to states that opted out. Only thing concrete with this garbage is its a disaster. Probably just a temporary one though.
 
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Obamacare Signed Up 11.4 Million People for Year Two, U.S. Says - Bloomberg Business

About 11.4 million people signed up for Obamacare or renewed their coverage for 2015, raising the possibility that enrollment may surpass the administration’s goal in the second year of the program.

Enrollment closed Feb. 15 for coverage through health plans offered on the marketplace created by the Patient Protection and Affordable Care Act. People signing up for insurance must pay their first premium to complete enrollment and gain coverage. The Obama administration hopes to have at least 9.1 million people paying for coverage bought through government-run marketplaces this year.
 
About 11.4 million people signed up for Obamacare or renewed their coverage for 2015,

The Obama administration hopes to have at least 9.1 million people paying for coverage bought through government-run marketplaces this year.
So 20% of the enrollments are useless? Why is it even a stated goal?
 
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and putting them in charge of healthcare, I mean what could possibly go wrong here

The worst part of it is the extension of the enrollment period to prevent the penalties. The rules are changing in real time to fit their political needs at the moment. What part of this crap can we count on?
 
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The worst part of it is the extension of the enrollment period to prevent the penalties. The rules are changing in real time to fit their political needs at the moment. What part of this crap can we count on?

I think you said it quite nicely in your second sentence. We can count on the rules changing to suit their political needs.
 

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