There has been lots of healthcare news in the past two weeks. First, I hope all of you read my RACmonitor e-news article from July 6 about the right observation rate. If you didn’t, here’s a preview: I did it. No, I did not find the right observation rate, since one does not exist. But what I did do was ascertain the national average observation rate for traditional Medicare patients. And that rate is: 12.18 percent. But you are forbidden to ever quote that number unless you read my article and understand all the nuances and caveats that go along with it. For instance, it does not include critical access hospitals (CAHs), and I arbitrarily limited it to hospitals with over 50 beds. Now remember, 12.18 percent is not the “right” rate for your facility. The right rate for your hospital is whatever rate you have when every patient is placed in the right status. I must note, though, that what really shocked me about the data was the number of hospitals, many of them quite large, that had no Medicare observation stays at all. Either the database I was using is terribly flawed, or some hospitals are just making up their own rules.
Next, I am sure many of you have seen articles talking about the epidemic of medical errors and the many patients who suffer harm while hospitalized. These claims, of course, are often inaccurate. These fearmongers take small studies and extrapolate them to every patient in every hospital in the U.S. It’s terribly inappropriate statistical manipulation, but it sells books and inflates the egos of these so-called experts. Well, last week the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) seems to have jumped on the bandwagon by publishing their toolkit for identifying patient harm.
It’s really concerning.
Read the full article here.
Dr. Ronald Hirsch is Vice President of the Regulations and Education Group at R1 RCM Inc. Dr. Hirsch was a general internist and HIV specialist and practiced at Signature Medical Associates, a multispecialty practice located in Elgin, IL. He was Medical Director of Case Management at Sherman Hospital in Elgin, IL from 2006 to 2012, where he was Chairman of the Medical Records Committee from 1995 to 2012, and also served on the Medical Executive Committee. Dr. Hirsch is certified in Health Care Quality and Management by the American Board of Quality Assurance and Utilization Review Physicians, certified in Revenue Integrity by the National Association of Healthcare Revenue Integrity, and on the Advisory Board of the American College of Physician Advisors. He is on the editorial board of RACmonitor.com. He is the co-author of The Hospital Guide to Contemporary Utilization Review, with the third edition published in 2021.