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Friday, December 14, 2012

AHA Finds Medicare Is Spending More on Sicker Patients

by Nathaniel Weixel

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The American Hospital Association came out with a report recently that found Medicare patients are living longer, but as they age they’re also getting a lot sicker. Like multiple chronic conditions sicker (obesity, diabetes, hypertension). The more chronic conditions a patient has, the more “complex” and “severe” the patient is. And the more complex these patients are, the more it costs Medicare to treat them. 


The fact that sicker patients cost more isn't exactly groundbreaking news. However, AHA makes the point that the Centers for Medicare & Medicaid Services believes that patient complexity and severity of illness has not really changed. CMS acknowledges that reported severity has been increasing, but they say it’s because of coding changes. A new coding system that was adopted in 2008 is much more specific than the older one, and so CMS, in trying to make sure that coding changes did not make Medicare pay more for the same services and patients than it would have paid before the new system, has continually cut annual hospital payments.

AHA has always protested these cuts, but their report is an attempt to show evidence that patients really are getting sicker, and it’s not just because of coding changes.

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