Approximately $520M in Medicare, Medicaid fees went towards avoidable hospital stays

As per a recent report titled “Potentially Preventable Hospitalizations in Pennsylvania,” out of nearly 185,000 patients in Pennsylvania who underwent hospital stays that could have been avoided in 2010, taxpayer-supported programs paid for about 83,000 of them. Medicare Plan and Medicaid payments amounting to about $521 million could have been prevented with better outpatient care.

The report was made public by the Pennsylvania Health Care Cost Containment Council, or PHC4, earlier this month. PHC4 is an independent state agency formed in the year 1986. It supplies information on health-care costs to employers and employees, created after the urging of business and public-sector labor groups.

Medicare Plan payments of $480 million covered potentially avoidable hospitalizations, like bacterial pneumonia, asthma and heart failure. The average cost per stay was $6,209 for 77,386 patients, or around 41 percent of all stays observed in the report.

According to the report, apart from that an extra $41 million in Medicaid payments went toward similar stays. Payment figures from private insurance companies making up the difference were not present to the council in drafting the report.

The aim of the report was mainly to identify flaws to see what the health-care industry could do to cope up with unnecessary hospital stays.

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