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Medicare Hospital Bonus 2019

Bob Vineyard · June 28, 2020 · Leave a Comment

Do you know about the Medicare hospital bonus program? Hospitals can get cash for better results. The idea sounds good in theory, but there is a dangerous underbelly to this plan. (UPDATED 6/28/2020)

The Centers for Medicare and Medicaid Services said on Tuesday that 55%—more than 1,500 hospitals out of approximately 2,700 facilities participating in the program—got a slightly higher Medicare payment under the program. Overall there will be $1.9 billion in incentive payments for hospitals in federal fiscal year 2020, which runs from Oct. 1 until Sept. 30, the same amount as fiscal 2019.

“The highest performing hospital in FY 2020 will receive a net increase in payments of 2.93 percent, and the lowest-performing hospital will incur a net decrease in payments of [negative] 1.72 percent,” the agency said.

Fierce Healthcare
Medicare hospital bonus

Quality of Care and Medicare Hospital Bonus

Quality of care bonuses. What could possibly go wrong?

So how does Medicare decide winners and losers?

Eight of the current 25 quality standards, Yahoo News reported, are based on patient satisfaction: communication with nurses; communication with doctors; responsiveness of hospital staff; pain management; communication about medicines; cleanliness and quietness of hospital environment; discharge information and overall rating of the hospital.

The rest are based on  how often hospitals followed clinical standards of care, such as controlling heart surgery patients’  blood sugar levels and giving them beta blockers to lower their blood pressure.

Georgia Health News

All sounds so simple. If a hospital delivers better results, and you are a satisfied customer, they can get a Medicare hospital bonus.

Do you think hospitals might “cherry pick” the Medicare patients they take in and the type of services they will provide to Medicare patients? And does it matter if you have a Medicare Advantage plan or original Medicare and a Medicare supplement plan (where you can choose your doctor and hospital)?

The maximum amount any hospital could gain or lose was 1 percent of its regular Medicare payments.

For nearly two-thirds of the hospitals, the changes are less than a quarter of a percent, KHN said. Still, for hospitals with a high number of Medicare patients, hundreds of thousands of dollars are at stake.

The caps will rise to 2 percent over the next four years.

The maximum Medicare hospital bonus (or penalty) now is 1%, rising to 2%. But will it stop there or keep climbing?

If a hospital can game the system in hopes of qualifying for the maximum bonus, how many really sick patients with expected poor outcomes do they have to reject in order to earn the highest kickback from Medicare?

This is about more than money. It is about your health and quality of care. Georgia Medicare Plans is concerned about your health and the health of your wallet. Save money by comparing your existing Medigap rates with an instant GA Medigap quote.

How Do Georgia Hospitals Compare to Other States?

How does quality of care in Georgia stack up against other states?

Georgia Health News reveals

Some other Southern states had higher percentages of hospitals getting bonuses than did Georgia. In both North Carolina and South Carolina, 69 percent of hospitals are receiving the extra payments; Alabama, 64 percent; Florida, 57 percent; Kentucky, 53 percent.

Louisiana equaled Georgia’s 51 percent performance. Performing worse than Georgia were hospitals in Tennessee, at 40 percent, and Mississippi, at 39 percent.

Does this mean you can receive better care in other states?

Not necessarily, but these are figures that cannot be ignored.

Budgeting for Healthcare Costs

It is impossible for most retirees to cover the OOP (out of pocket) cost of health care without insurance.

Original Medicare pays 80% of your outpatient health care costs but the remaining 20% can be staggering.

Most retirees worry about paying hospital bills, but the MAJORITY of medical claims are OUTPATIENT.

Original Medicare does not cap your OOP health care costs. You pay until you get better, run out of money or die.

A cost effective Medicare supplement plan from Georgia Medicare Plans can give you piece of mind.

Shop and compare rates. Get your personalized Medigap rate report. Invest 10 minutes to call and ask us ANY Medicare question. Either you like what you hear or you don’t.

I will stay on the phone with you as long as you have questions. Never a sales pitch. No obligation to buy.

I call this my offer you can’t refuse.

Medicare hospital, hospital admission penalty, medicare, medigap rates

Medicare Hospital Admission Penalty

Bob Vineyard · December 12, 2012 ·

The Medicare hospital admission penalty may impact your ability to obtain treatment as a hospital inpatient. Haven’t hear of the Medicare hospital admission penalty?                                 medicare hospital admission penalty

Not surprising.

Most haven’t.

Twenty Colorado hospitals face penalties in the coming year for seeing too many discharged Medicare patients come back within a month, small hits that nevertheless sting in an era of quality measurements and patient-centered care.

Hospitals will lose up to 1 percent of the next year’s Medicare payments if they readmitted too high a proportion of their patients

9 News, “Medicare hospital admission penalties”

How does this impact you?

In an effort to avoid the Medicare penalty, hospitals may decide to refuse admission to those with chronic or serious medical conditions.

Think about it.

If your medical condition can be treated and discharged with little likelihood of recurrence, finding a hospital that is willing to admit you should not be a problem. But those with difficult to treat conditions will find hospital admission a challenge.

Though a small portion of future bills, the penalties add up as Medicare payments often constitute half of a hospital’s overall revenue. On a $10,000 inpatient bill, a 1 percent penalty would cost the hospital $100 of the Medicare reimbursement.

Bit by bit, the Medicare hospital admission penalty can be devastating.

Medicare hospital admission penalty, medicare, medigap rates

Don’t Buy Something You Don’t Need

https://www.georgia-medicareplans.com/wp-content/uploads/2020/05/Buying-Something-You-Dont-Need-GA-Medicare-Plans.mp4

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