Hospital Administrators

[jethreauxdawg]

I think we have a few on here. Help me out. I was told today by someone in the healthcare field that a hospital is given $13k from the govt for every patient they classify as having covid (not sure if that’s total or daily), and that it grows drastically if they are moved to ICU and again if further care such as a ventilator is needed. Is this correct?

 

[ronpolk]

Not a hospital administrator but with my I see the financial statements of a lot of hospitals and I have seen zero evidence of this. In fact, most hospitals are losing lots of money. Some bigger hospitals are going to lose in the 100’s of millions.

I do believe the government is paying some (maybe all) of hospital bills related to covid but I think they follow the same reimbursement rates as Medicare.

 

[Go Budaw]

You don’t have to be a hospital administrator to answer this....just Google the terms of the CARES Act. Hospitals get a bump for Medicare patients who test positive for COVID. They get a bigger bump if the same Medicare patient gets put on a ventilator. For privately insured patients, they get neither benefit regardless of positive test or need for ventilator. For COVID coded deaths, they also get no additional funding.

 

[PineGroveBully]

And even that bump isn’t close to $13k from what I’ve read is it? And the cost of having a patient in an ICU on a ventilator is enormous. Most hospitals struggle to break even on Medicare/Medicaid patients. They aren’t furloughing nurses to save money, they’re doing so as to not lose more money. Unfortunately I have had much more of a look into hospital systems than I would prefer.

 

[Go Budaw]

And even that bump isn’t close to $13k from what I’ve read is it? And the cost of having a patient in an ICU on a ventilator is enormous. Most hospitals struggle to break even on Medicare/Medicaid patients. They aren’t furloughing nurses to save money, they’re doing so as to not lose more money. Unfortunately I have had much more of a look into hospital systems than I would prefer.

According to this, the $13,000 isn’t far off, but its percentage based it seems. Hospitals get a 20% bump on the normal Medicare payout for a confirmed case, and 40% more if they are placed on ventilator. My guess is that $13k is somewhere around the average based on standard Medicare payouts.

https://www.tampabay.com/news/healt...ble-financial-incentive-of-covid-19-patients/

 

[RocketDawg]

They might get some money for Covid patients, but if they do it's not enough to keep things going. I read on al.com a month or so ago that UAB, the largest hospital in Alabama, was projected to lose something like $280M by the end of the year, and they have laid off (I think) about 350 people at the time, and reduced salaries of higher paid employees. Apparently hospitals make money on elective surgeries and presumably other admissions that don't involve surgeries, but elective surgeries were stopped for quite some time.

 

[Leeshouldveflanked]

What about Covid Deaths... my Dad’s 90 year old first cousin passed away and it was classified as Covid.... we don’t know if he had it or not but he didn’t have much time ahead of him regardless...

 

[Go Budaw]

What about Covid Deaths... my Dad’s 90 year old first cousin passed away and it was classified as Covid.... we don’t know if he had it or not but he didn’t have much time ahead of him regardless...

Hospitals get no benefit from COVID deaths over any other form of death.

 

[ronpolk]

According to this, the $13,000 isn’t far off, but its percentage based it seems. Hospitals get a 20% bump on the normal Medicare payout for a confirmed case, and 40% more if they are placed on ventilator. My guess is that $13k is somewhere around the average based on standard Medicare payouts.

https://www.tampabay.com/news/healt...ble-financial-incentive-of-covid-19-patients/

I don’t understand the 20% or 40% more than normal? What is the normal that the payment is being compared to?

I can tell you this isn’t a big money grab by hospitals. My wife is a NP at a hospital in Jackson and most of the people she sees don’t even get a test. If this was really a money grab, I guarantee every patient that walked in the door would get a test.

 

[Leeshouldveflanked]

Hospitals get no benefit from COVID deaths over any other form of death.

He passed away in VA Nursing home.

 

[57stratdawg]

I love the “COVID death total isn’t real because hospitals are being paid per CV death” crowd.

 

[Go Budaw]

I don’t understand the 20% or 40% more than normal? What is the normal that the payment is being compared to?

I can tell you this isn’t a big money grab by hospitals. My wife is a NP at a hospital in Jackson and most of the people she sees don’t even get a test. If this was really a money grab, I guarantee every patient that walked in the door would get a test.

I don’t know enough about Medicare specifically to give a super educated response, but my understanding is that hospitals receive standard Medicare payout amounts based on every billed part of the stay (room nightly cost, medicines, procedures, tests / diagnostics, and everything else). I imagine there may be regional variation on these payouts based on cost of living in a given area. I imagine a hospital stay in downtown San Francisco is a lot more than in Iuka, MS for just about any reason, just due to the higher cost of the hourly and salaried employees.

Anyway, the 20% / 40% of additional funding is based on the total roll-up cost from all those standard payouts. And I think hospitals are still losing money on every Medicare COVID patient regardless.

 

[SirBarksalot]

You’re going to get it...that we know.

 

[Delmar]

What you’re probably suggesting would be defrauding the federal government. If that happened there would be a whistleblower in line for 15%-25% of whatever the government recovers. We’d be talking about serious money.

 

[PineGroveBully]

Hospitals make a good portion of their money on (non-emergency) ER visits. People that get triaged, maybe blood work/X-ray and 10 mins with an actual Dr and insurance gets billed a couple grand. With less travel and fear of Corona has drastically cut down on ER visits.

 

[Len2003]

They might get some money for Covid patients, but if they do it's not enough to keep things going. I read on al.com a month or so ago that UAB, the largest hospital in Alabama, was projected to lose something like $280M by the end of the year, and they have laid off (I think) about 350 people at the time, and reduced salaries of higher paid employees. Apparently hospitals make money on elective surgeries and presumably other admissions that don't involve surgeries, but elective surgeries were stopped for quite some time.

The harsh truth is that hospitals need surgeries and elective procedures to stay afloat. Any other patient is a drain on the system, and the hospital doesn't really want them there. This includes COVID patients. These patients suck the system dry, and hospitals have to eat the cost. This is the very harsh reality of our healthcare system. It could easily cost $100,000 to take care of a COVID patient in ICU. Very easy. I've seen these spread sheets with costs.

Our healthcare system was already a house of cards and has been propped up for awhile. The lay public doesn't really understand how close to collapse our healthcare system has been, and COVID is running it further into the ground. I could totally see some hospitals going under in the next year.

 

[Len2003]

I don’t know enough about Medicare specifically to give a super educated response, but my understanding is that hospitals receive standard Medicare payout amounts based on every billed part of the stay (room nightly cost, medicines, procedures, tests / diagnostics, and everything else). I imagine there may be regional variation on these payouts based on cost of living in a given area. I imagine a hospital stay in downtown San Francisco is a lot more than in Iuka, MS for just about any reason, just due to the higher cost of the hourly and salaried employees.

Anyway, the 20% / 40% of additional funding is based on the total roll-up cost from all those standard payouts. And I think hospitals are still losing money on every Medicare COVID patient regardless.

Medicare gives the hospital a set lump sum based on the diagnosis. For example, every person that has a heart attack gets X amount of money.

 

[PineGroveBully]

Pretty spot on

 

[Go Budaw]

Medicare gives the hospital a set lump sum based on the diagnosis. For example, every person that has a heart attack gets X amount of money.

Makes sense. But given that COVID was a brand new disease, I imagine there was no “X” amount set for it yet. Maybe that is where the $13k comes from? Anyway, I’m sure you can explain better than I can.

 

[dorndawg]

If hospitals were interested in committing fraud (which I presume they emphatically are not), they'd vastly understate the number of c19 cases. That would get their "regular" business back rolling quicker, which as poster above discuss, is their bread and butter.

 

[L4Dawg]

I love the “COVID death total isn’t real because hospitals are being paid per CV death” crowd.

People will go to great lengths to try and convince themselves it's not real.

 

[SirBarksalot]

The harsh truth is that hospitals need surgeries and elective procedures to stay afloat.

This. If anyone thinks a hospital would rather take care of COVID patients at the expense of elective procedures they’ve lost their minds. I don’t think people realize what was happening during the shutdown. How many hospital personnel were furloughed or working half of normal hours.

smaller hospitals especially. I heard about some closed door meetings between administrators and surgeons, where they were told to get back at it, before reopening officially.

 

[rynodawg]

It must be spreading around on FB. I have a relative that gets news exclusively from Facebook memes, and was trying to explain to me a couple weeks ago that COVID diagnoses are faked by hospitals. It sounded far fetched and I didn’t care enough about hospital funding to look into it.

 

[L4Dawg]

It must be spreading around on FB. I have a relative that gets news exclusively from Facebook memes, and was trying to explain to me a couple weeks ago that COVID diagnoses are faked by hospitals. It sounded far fetched and I didn’t care enough about hospital funding to look into it.

I see it 5 times a day on Facebook. I gave up replying to it. You can not get these people to change their minds no matter what.

 

[Bucky Dog]

My feeling is that prior to opening elective surgeries and such back up, the hospitals were struggling financially, and still are to an extent. CMS does pay a higher rate for COVID patients per the CARES Act than a non COVID. You could definitely see where a number of patients with COVID like symptoms were coded as such to take advantage of the extra funds.

 

[mstateglfr]

And even that bump isn’t close to $13k from what I’ve read is it? And the cost of having a patient in an ICU on a ventilator is enormous. Most hospitals struggle to break even on Medicare/Medicaid patients. They aren’t furloughing nurses to save money, they’re doing so as to not lose more money. Unfortunately I have had much more of a look into hospital systems than I would prefer.

Can you explain why the cost of having a patient on a ventilator is enormous?
Is the operating cost of a ventilator really high for some reason...like it uses a bunch of electricity or it requires a change of a filter every hour and the filter costs $1000 each?
What specifically makes it enormous?

I'm completely ignorant on this. I see it as an item the hospital already owns and the cost to own has already been accounted for. I'm guessing this is a simplistic view of reality.

...or when you say 'cost', do you mean the amount the hospital charges for ventilator use is enormous?

 

[mstateglfr]

The harsh truth is that hospitals need surgeries and elective procedures to stay afloat. Any other patient is a drain on the system, and the hospital doesn't really want them there. This includes COVID patients. These patients suck the system dry, and hospitals have to eat the cost. This is the very harsh reality of our healthcare system. It could easily cost $100,000 to take care of a COVID patient in ICU. Very easy. I've seen these spread sheets with costs.

Our healthcare system was already a house of cards and has been propped up for awhile. The lay public doesn't really understand how close to collapse our healthcare system has been, and COVID is running it further into the ground. I could totally see some hospitals going under in the next year.

Could you list some examples of what costs so much to care for an ICU covid patient?
Staff is already working, the room already exists, so those aren't really increased over regular ICU cases.
Does there need to be more staff on hand for each covid case compared to other ICU cases? Or is the PPE worn super costly compared to regular protection for other ICU patients?

...or is the $100K cost you refer to an amount that includes regular markups($10 aspirin for a hypothetical) and so it isnt a 'cost' but rather 'charges'?

 

[Nunya.sixpack]

I see it 5 times a day on Facebook. I gave up replying to it. You can not get these people to change their minds no matter what.

View attachment 16591

 

[DawgNsuds]

I'm not a Hospital Administrator, but I have a close relationship with one. Hospitals in general are struggling with Covid-19, it has cost them far more financially than any bump in COVID funds. The reason being the procedures that are financially beneficial to the hospitals were mostly shut down. If your question is, are hospitals making money off of COVID-19, the answer is largely no. Could there be some over reporting of COVID-19 due to the guidelines that they were provided, then absolutely to a point.