The Hospital Discharge and Re-Admit Cycle

The federal government has major issues with the cost of health care programs, at the same time the reform movement is trying to expand insurance coverage.

One of the targets is the discharge / re-admit issue with Medicare patients.

Hospitals have incentives to discharge elderly patients to home or an ltcf, but re-admissions are quite common, driving up cost.

Physician judgments and family wishes play into this, and these factors may be difficult to change.

One proposal is "payment bundling," the hospital would get a single payment and then must reimburse the ltcf. This could be difficult for ltcfs, but could also provide incentives for better cooperation and coordination of services.