Here's an interesting development: Some states are passing limits on the number of inpatient days per year for adults on medicaid. It ranges from 10 days in Hawaii to a new proposal of 25 days in Arizona. This is all in an effort to decrease cost.
Lets say your patient has an illness that requires more than 10-25 days...or that your patient comes to the ER and needs to be admitted but has used up their yearly inpatient days...then what? They will be admitted to the hospital because the hospital is not going to throw them out. For liability reasons, for EMTALA reasons, they will get the care they need and the hospital will absorb the cost.
These changes, along with the coming 30% cut in reimbursement of physician fees come 2012, are going to have a dramatic effect on hospitals bottom line. I really wonder how the government and our country expects hospitals and doctors to deal with all of this. We will see more hospitals closing, more doctors will refuse medicare/medicaid patients.
At a time when medicare and JCAHO are requiring more and more of hospitals, reimburnsement keeps going down. It doesn't make sense. People want sophisticated treatment and the latest technology, but the money is not there to pay for it. Health care in this country is like a runaway train that gets closer and closer to crashing. Like most problems, we will no doubt wait until the crash happens.