Prof. Prof.
Bryan Caplan bcaplan@gmu.edu. Santa Fe Photographic Workshops Santa Fe, New Mexico. Health Care Is Next Frontier for Big Data. Hospitals Caught Between a Rock and a Hard Place Over ’Observation’ Cheryl Clark, for HealthLeaders Media , September 15, 2010 Like thousands of acute care facilities across the country, Immanuel St.
Joseph's, a Mayo system hospital staffed for 161 beds in Mankato, a small town 80 miles southwest of Minneapolis, is caught between a rock and a hard place. On one side, administrators and physicians are required by Medicare's strict billing criteria to place certain patients in "observation" status rather than admit them as regular inpatients, explains ISJ chief financial officer Jim Tarasovitch.
That means ISJ can submit claims for only one-third of what the facility would be reimbursed if the patients were officially admitted, or the difference between $4,500 per day and $1,500 "even though the care of the patient and the expenditures we do on that patient are exactly the same," he says. No matter what, hospitals like ISJ can't win.
Getting started.