So, I'm sure a lot of you know Medicare's new idea about how to cut cost -- I mean enhance patient safety and quality of care.
To decide that once you have been admitted to the hospital for CHF that you shouldn't be seen back in a hospital for 30 days for any reason, even if said-reason-for-return-visit has NOTHING to do with CHF, Medicare just won't pay. Brilliant. So when granny has a fall and hip fracture 28 days after a 3 day hospitalization for CHF, Medicare calls foul and refuses to pay? The brazen ignorance is breathtaking.
Of course, I'd like to think that it isn't my problem if my hospital isn't getting paid for these things. I'm supposed to be immune to collections. Except in a healthcare system that has never valued primary care physicians, it suddenly finds itself without a way to get adequate follow up for our CHF discharges. I ask for a 1-2 week follow up with the PCP and they can't get them in for a month? Well damn. The solution must be to make the hospitalists do it. We'll call it something fancy ... like "bridging" clinics. It's like putting a band-aid on a spurting radial artery.
How many of you are being threatened with this?
This honestly makes me want to look into practicing medicine in New Zealand or Australia. Or to get out altogether. We have a healthcare system that has ensured (by virtue of its insuling primary care reimbursement) such a shortage of PCPs, that when we need them most, we don't have them. So let's make our hospitalists assume duties that make their job look more and more like the career they shunned. Then let the financial penalties roll downhill. If the hospital isn't getting paid, let's punish the hospitalists for their inability to make up for our shortsightedness.
Keep it up, CMS. When you punish our hospitals like this, they make our lives hell. Because they have shareholders to answer to. Less and less of us are going to put up with this abuse. As if you don't have enough doctors opting out of your insulting reimbursements... can you really afford to continue to piss us off?