Hospitals forced to not see non-emergent patients under Obamacare beginning January 2014
Hospitals and Emergency Centers are being forced to stop rendering healthcare to non-emergent patients beginning January 1, 2014 under the Affordable Healthcare, Obamacare guidelines.
The DSH or Disproportionate Sharing Hospitals will start seeing a large decrease in reimbursement rates to hospitals currently treating indigent, non insurance bearing patients.This action will force hospitals to seek alternatives to delivering “free” or “uncompensated” care just to survive.
Hospitals across America are starting to either opt to not see uninsured patients in an emergent setting, demand payment up front, link payment to a bank account (as reported by BCN in previous blogs) in order to survive.
DSH Reductions will force Emergency rooms, hospitals and providers to resort to third world tactics to survive in a post Obamacare reimbursement world.
Shadac reports; “A national total of Medicaid DSH money is allotted across the states each year, with a 2011 total of $11.3 billion (closer to 20 billion in 2013). ”
“The ACA (Obamacare) reduces the annual Medicaid DSH total by $500 million in 2014; $600 million in 2015; $600 million in 2016; $1.8 billion in 2017; $5 billion in 2018; $5.6 billion in 2019; and $4 billion in 2020.”
“In implementing these reductions, the statute requires HHS (Health and Human Services) to develop a “DSH Health Reform methodology” that imposes the largest percentage reduction on states with the lowest percent of uninsured or on states that currently do NOT target their DSH payments to hospitals with high volumes of Medicaid patients or high levels of uncompensated care.”
Uncompensated care, decreased allotments to hospital and providers will tip the scale to the patient placing the burden of payment upon them. Those who wish to remain uninsured and reporting to a hospital with a non emergent condition will begin to be turned away. There is no other viable scenario at this juncture.
If you work in or are associated with providing care in an Emergent Center you know that a great percentage of what presents to the Emergency Room, the entry point of any hospital, is either non emergent or uninsured. This population, presently and in the past, was pretty much taken care of by the DSH allotment now being taken away by the Affordable Healthcare Act or Obamacare.
This action will leave millions vulnerable and seeking a setting where healthcare is delivered by a cash only scenario with very little regulation, a black market approach if you will. The underground provider or nurse with the ability to diagnose and treat on the spot for cash, bypassing the whole system. Think it will not happen?It’s already happening.
The Patient Affordable Care Act was intended to catch those patients or provide the net that was previously cast by hospitals under the Disproportionate Sharing Hospital plan. That safety net is now being removed and many are not going to like the outcome. The net now has a wide hole in it and patients will be falling through rapidly.
Obamacare was ideally supposed to be the safety net pulling in some 40 million plus uninsured, give them “free or a terrific deal” on an insurance policy that would fix all their healthcare needs, off setting the total cost of healthcare, leaving “all” to share the load, so to speak.
What the “healthcare system” and the patient population system failed to see coming was the disastrous roll out of Obamacare and the many unexpected costs and high premiums associated with it and the amount of people running from it!
With premiums as high as several thousands of dollars a month for a family plan, three to five hundred for a single young adult you can easily see why those this bill was intended to help will only hurt.
The recent ACA website rollout with it’s whopping 6 patients enrolled and ballooning premiums has left many seeking healthcare seeing a bad case of sticker shock as hospitals and providers look for survival measure to mediate the losses, to balance their budgets.
The proportional shift of most of the cost to young people is forcing millions to reevaluate the “need” to purchase healthcare instead opting to pay the relatively small fine at the end of the year. This leaves many with the inability to seek non emergent healthcare.
A dilemma has surfaced with no quick fix in site and only surmounting issues.
Millions of Americans and financially strapped families choosing to not participate in Obamacare are facing yet another hurdle.
Higher premiums, cancelled policies, opting to not purchase government insurance has left many in a quandry with few options leaving many financially strapped individuals to choose between purchasing a bad government forced insurance, not seek medical treatment or ultimately choosing to say the heck with it all, Im putting food on the table for my family. The latter is the dignified approach and probably the preferred alternative.
This shifts most of the cost now to the employer, small businesses, the middle class and the everyday citizen……you, John and Jane taxpayer.
Higher taxes, up to 20 new taxes in all, higher premiums, increased shared costs with fewer participants leaves hospitals with no other viable choice but to cease treating patients ie; the uninsured, the immigrant and the non emergent.
EMTALA, a regulation that forces hospitals and providers to care for patients regardless of their ability to
pay will be challenged under new Obamacare guidelines.
The challenge will now be if you want healthcare in my hospital, you must purchase the insurance that your government is forcing upon you or we cannot see you!
Obamacare or the Affordable Care Act has created a major “boondoggle” of sorts.
It has offered unaffordable, unreliable care, a poor payment structure, reduced reimbursements for hospitals, higher premiums while forcing you to participate and not doing so will result in higher taxes and fines for you not doing so.
Obamacare has forgotten to close or mend the hole in the safety net. That proverbial hole being hospitals have now trumped the administration using their own rules closing the door to healthcare by opting out of your health care if you don’t buy the mandated government insurance.
What does a patient do? What does a hospital or provider do?
Well, simply put, patients will continue out of neccesity to not purchase this high premium government insurance forcing hospitals and providers to shut their doors till you purchase the insurance for your non emergent needs?
Will the government now say to the hospitals you must treat these patients regardless of their ability to pay per EMTALA regulations or force you to buy the insurance that the hospitals are now both saying you must buy to dart the door of our emergency room?
Nothing would surprise me but a simple statement like that would not support the governments plan of forced or mandated healthcare for everyone, this rendering EMTALA non-existent.
Obamacare has contributed to this boondoggle by introducing the Individual Shared Responsibility plan and has placed upon you yet another way to make you pay for your healthcare.
Introducing the Individual Shared Responsibility plan under the Affordable Care Act directly from the ACA healthcare exchange site.
Beginning January 2014, the Individual Shared Responsibility provision calls for each individual to either have minimum essential coverage (whatever that is) for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return.
On Aug. 27, 2013, the Department of the Treasury and the IRS issued final regulations on the Individual Shared Responsibility provision, Notice 2013-42….
The open enrollment period to purchase health insurance coverage for 2014 through the Health Insurance Marketplace runs from Oct. 1, 2013, through March 31, 2014.
The American Emergency Physician Association has prepared a statement regarding reimbursement under the ACA or Obamacare and I summarize. (See link below for full statement)
The ACA forces doctors, hospitals and providers to treat every pt under EMTALA while reimbursement rates go down.
The ACA forces non good faith reimbursement scenarios where the hospital is forced to take care of patients with shrinking reimbursement from the government while private insurers reap the benefit of taking advantage of a low loss scenario having the distinct advantage of bypassing the benefit of a high cost uninsured patient population.
This has left hospitals, mainly Emergency Centers to force payment up front or stop treating non emergent patients.
Recently information was passed to Bradley County News from a social media website that depicts the following,
The Appalachian Regional Healthcare system in Kentucky has made the unprecedented move to opt out of treating non-emergent patients.
A flyer or memo has recently been sent out to patients and posted in their ERs which states, “Attention patients: Consistent with the Affordable Care Act, we will no longer be able to see non emergent patients without healthcare coverage beginning January 2014!” The saga begins!
Can you see what is happening here?
The government is saying you must purchase insurance, the hospitals must provide care regardless of ability to pay under EMTALA, decreasing reimbursement to those providing care and now the hospitals are taking the desperate steps to say NO, we can no longer see you unless you purchase mandated insurance by the Federal government.
The end scenario:
Patients will be unable to enter the ER for non emergent care. They will be unable to pay for a Doctors office visit. This will leave millions without a portal of entry and forced to stand outside hospital doors begging for care and access or seek alternative, perhaps underground behind the scenes treatment inside a newly developed black market.
This is reminiscent of third world country healthcare, then again this end product is intentional isn’t it?
It is about control of the populace?
Sources of info:
Disproportionate hospital share is going down!
DSH Hospital Allotments through 2011. TN included.