Medicare Seeks To Limit Number Of Seniors Placed In Hospital Observation Care

The "observation care" designation is a thorny one - for the providers, as well as, the Medicare beneficiary.  The patient often doesn't realize that they haven't been admitted, and end up with increased financial obligations because of it.  If a person has a Medicare Advantage plan, this can be especially troubling, since in many of the plans on the market, the patient would be responsible for 20% of all outpatient services received, rather than a straight 'hospital inpatient' daily co-pay.

The difference between the two can be enormous, especially if expensive tests are done while the person is considered to be an "outpatient".  There are other implications as well, related to requirements to be admitted into a nursing home after a hospital stay.  The requirement to have coverage in that instance is that the patient has been an "inpatient" for 3 consecutive days.  Outpatient status doesn't count.  Read more in the Kaiser Foundation & Washington Post article here . . .