Calif. Hospitals Prep to Treat Fewer Patients Under Obamacare

Monday, 05 Mar 2012 01:49 PM

By Tim Plaehn

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California hospitals are making plans to treat fewer patients because of radically different mandates under Obamacare. President Barack Obama’s signature legislation will force more patients to go to doctors offices and clinics for treatment and reduce care received in hospitals, according to the Los Angeles Times.

Obamacare is designed to reward hospitals for providing quality care and penalizing them if care is determined to be inefficient or patients are treated more than once for the same condition. The pending rules are forcing the state's hospitals to decide which types of care they want to offer to remain profitable, the Times reported.

Some of the changes probably are past due, such as instituting electronic record systems to replace the paper paths hospitals use now and looking into partnerships with doctor groups to monitor quality of care, health officials believe.

On the downside, some services won’t be offered in any hospitals in an area if the type of care is determined to be not cost effective. Hospitals also might turn a repeat patient away toward less well-equipped clinics if repeated treatment of the patient's condition risks a penalty under the guidelines.

California hospitals now receive more than half of their revenue from Medicare and Medi-Cal, the state-subsidized healthcare system for those without private insurance. The reimbursement rates from these agencies result in financial losses, and the hospitals rely on the payments from private healthcare to be profitable.

The whole financial model for hospitals must change because the healthcare reform rules also will cover private reimbursement rates, the Times reported.

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