AHASTAT blog: Decision to admit or discharge patient complex medical decision

In an AHASTAT blog post today, AHA President and CEO Rick Pollack challenges a recent New York Times column suggesting there is a “hidden financial incentive” behind shorter hospital stays and lower readmissions. “The bottom line is that the decision to admit or discharge a patient is a complex medical decision between a patient and physician,” Pollack writes. “…It is no coincidence that the increase in observation services occurred with the advent of the Recovery Audit Contractors program. Too often, the medical judgment of treating physicians was second-guessed by RACs, which could evaluate a patient’s admission in hindsight, looking at the entire medical record rather than only the information that was known to the physician at the time of the admission. Fortunately, [the Centers for Medicare & Medicaid Services] has moved to curtail the egregious behavior of the RACs. The numbers show that readmissions are on the decline thanks to the hard work of America’s hospitals to improve care, provide better discharge instructions to patients and partner with patients and others in their communities to coordinate care after they leave the hospital. This success can continue as patients and physicians together make decisions about their course of care.”