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Format: 04/19/2014
Format: 04/19/2014


Pittsburgh Tribune-Review: Increase in number of 'observation cases' costly to hospitals

Monday, March 29th, 2010

By Luis Fabregas

 Dr. Sharon Kiely couldn't believe what the hospital case manager was telling her: After a three-day stay at Allegheny General Hospital, her 80-year-old patient was deemed by her health insurer to be an "observation case."

Even though the woman was hooked to IVs, couldn't keep down food and had lost about 40 pounds, the insurer said she didn't meet the medical criteria of an inpatient.

"I was horrified," Kiely, an internist at the North Side hospital, said about the incident several weeks ago. She called the insurer, whom she declined to name, and argued strongly enough to force the company to change the woman's status. "The doctors need to be taking care of patients, not arguing about their care."

During the past year, Medicare and commercial insurers increasingly have labeled patients as "observation cases," saying they're not sick enough to be hospitalized — but not well enough to go home. Doctors, hospitals and consumer advocates say the trend is costing patients and hospitals.

They say the practice is particularly harmful to Medicare patients. If they are discharged without a record of a three-day inpatient stay, Medicare recipients are denied coverage for skilled nursing home care. 

To read  more, visit the Tribune-Review website.

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