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Expanded access means more patients..
THE WAY.. that revenue has been decoupled from the FFS treadmill means that providers are not getting paid for their time. And by the way.. paying for non face to face time.. when you are reducing overall reimbursement pushes patients away from face to face time.
Ah.. yes quality is going down and its not being measured by any valid metric,
Tell me.. Does Obamacare require any physical functioning requirements prior to discharge? And post discharge?
Did Medicare require any metrics of physical functioning and independence prior to Obamacare that can be measured?
Oooops..no.
So patients are being sent home from the hospital.. and to avoid readmissions.. (which ARE being monitored)... hospitals are sending patients home just as sick or even sicker.. but are telling home health agencies that if they send them back to the hospital.. they are not going to get referrals. So home health agencies are keeping patients that are not doing well at home.. and if they have to transfer them.. they are sending them to OTHER hospitals to avoid getting dinged by the original hospital. Because the hospital is keeping a "score card".. on them.
They are doing the same thing with SNF's and even assisted livings.
They are telling SNF's.. that regardless of the patients needs and potential.. they need to be "discharged on this date". and too bad if the patient has the potential to improve past that level. And if you go over that date.. then you face hurting your "scorecard" and not getting transfers from the hospital.
That's if they are even sending the patient to a snf. I just had a patient enter my office who had a stroke.. who instead of going to rehab.. the hospital sent him to an assisted living where he languished there for 2 months.. with no OT. No SLP and PT once a week on average.
He only left that assisted living and got to us where he was admitted to a rehab because his family had a PT in it that understood what he needed and what against what the home health and assisted living wanted. And I had to personally intervene because it was the right thing to do.. even though financially it was going to hit us.
So.. yeah.. why bother to measure quality with valid measures... when you can listen to folks that have no clue of the actual provision of healthcare and what is actually going on spout off on ideology.?
If you are asking if the quality of our services are going down? YES.. YES THEY ARE. I treat more patients per day.. than I have before. I spend less patient time and more documentation time. Our facilities see more patients with less qualified staff. Our rehabs and home healths are being pressured by outside hospitals to provide what fits THEIR profit margin regardless of whats best for the patient.
I hope to god that you never have a family member have to suffer needlessly because of this system. Of course.. you won';t probably know... because you have no clue what SHOULD have occurred. And of course you don't want to know.
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This sounds quite disturbingly like the VA in action.
Could my prediction as to the quality and efficacy of government run healthcare ending up with everyone having healthcare like the VA been accurate? Hmmm.