Wednesday, September 19, 2012

Selig: Hospital keeping patients overlong to make money

Posted By on Wed, Sep 19, 2012 at 9:36 AM

John Selig, the director of the Department of Human Services, told an interesting story on NPR's "Diane Rehm Show" this morning in explaining the state's new approach to Medicaid cost controls.

The state is just starting to implement the "medical home" idea for Medicaid patients, in which doctors will be rewarded — after the fact — for managing the care of patients in a way that cuts down on unnecessary hospital stays, tests and other expensive procedures. Selig said there's no hard data yet, but that his department has assessed doctors and their expenses, and that one of those doctors, an ob-gyn, was dismayed by the "red marks" all over his record. He thought he was keeping expenses down well, and so did the state, Selig said. But in digging into the data, the state found that it was hospital charges keeping the doctor's Medicaid billing up because the hospital was keeping the patients a half day longer than other hospitals, the hospital said, "to make more money," "we do that because we get paid for it," Selig said. The doctor said that was easily fixable and that he would get with the hospital. Guests on the Rehm show — experts in health care cost management — said they hoped that approach would work.

We've got a call in to Selig for specifics on this and other analyses the department has made.

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