Medicare Patients Need to Stay Informed
A recent article in the Washington Post caught my attention and reminded me how important it is for anyone on Medicare to keep up with rule changes. This article is especially timely for any patient scheduled for a surgery because of some drastic changes to the list of surgeries that can be performed as a hospital in-patient. This new rule, put in place by the previous administration, forces many quite invasive surgeries to be done on an outpatient basis. In my view, this attempt to save money is very short-sighted and risks jeopardizing patient safety in outcomes.
By the end of 2023, the list — which includes a variety of complicated procedures including brain and heart operations — is scheduled to be gone.
CMS officials said the change was designed to give patients and doctors more options and help lower costs by promoting more competition among hospitals and independent ambulatory surgical centers. But they forgot one thing.
While removing the surgeries from the inpatient-only list, the government did not approve them to be performed anywhere else. So patients will still have to get the care at hospitals. But because the procedures have been reclassified, patients who have them in the hospital don’t have to be considered admitted patients. Instead, they can receive services on an outpatient basis.
CMS pays hospitals less for care provided to beneficiaries who are outpatients, so the new policy means the agency can pay less than it did last year for the same surgery at the same hospital and Medicare outpatients will usually pick up a bigger part of the tab.”