These Medicare changes have occurred in recent years and allow the hospitals to be a monopoly for government money. For example, some patients on this bundle may have a stroke and the hospital will get a lump sum of money for this patient’s care. If the patient leaves the hospital and requires home health or rehabilitation then the hospital has to share the money with those agencies. If the patient does not require any of these extra services, then the hospital gets to keep the money. The hospitals are now a monopoly, and only refer to medical agencies who agreed to limit the number of visits for these patients to therefore limit the amount of money that the hospital loses in paying for the patient’s care. So in essence, the hospital tells the hospital doctor how long the patient will stay in the hospital, regardless of their medical status. The hospital dictates to the follow-up care agencies (home health, rehabilitation, etc.) and tells them how many visits the patient will have, regardless of their medical status, or the consequence will be no referrals from this hospital. Of course, the hospital policy does not state this in written, legal documents, but the hospital has all of the power, and the best interest of the patient is not always the best interest of the hospital financial committee. And please don’t blame the employees or the doctors because they would no longer have a job if they do not comply. This has to change.
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