As cameras roll, providers raise hopes about hospital 'observation' stays

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James M. Berklan
James M. Berklan

It's been said for a long time that a picture is worth a thousand words. Moving pictures? Start multiplying the worth. Add some sound or speaking to those moving pictures, well now we're talking really, really big impact.

Everyone seems to realize it nowadays. With 100 hours of video being posted to YouTube every MINUTE, the medium's impact on the public is both profound and undeniable.

I'd also say it's likely irreversible, but you'll have to get back to me in a couple of decades on that one. Unknown is whether giving hundreds of millions of people the ability to create video will saturate the public's collective mind so much they'll start tuning out.

The point is — and this rarely sits well with print journalists — the powers of video and television are still supreme. This was personally hammered home again just a few weeks ago. I live in a suburb of a major U.S. city, a pretty quiet place that's comfortable in relative anonymity. It is generally ignored by major media, or overshadowed by other places that try harder to get noticed.

Two weeks ago, things changed. Our village received far more snowfall than surrounding suburbs in all directions, not to mention the Big City. For days, people for miles around seemed to take general pity on us. Awed, in fact, that we could survive nearly 20 inches of snow over just a few-day span.

My first thought was: Why do they care, since they usually don't? But then also: How do they even know?

Then it struck me. The Big City newswoman with the camera truck, broadcasting from the heart of our village. Two days in a row, in fact. (Was it stuck in a snowdrift? I wondered.)

Regardless, we were anointed as the besieged — the snow kings and queens, if you will. Why? Because the lady on the TV said so. She was even there in snowsuit, reporting live from some (over-exaggerated) snow scenes.

The power of broadcast video. That's why I think January 9 will wind up a watershed day for long-term care providers, and more importantly, many Medicare beneficiaries.

Although they weren't stuck in some snow bank, they have been getting snow-jobbed for far too long. Now, the wheels of change may be putting an end to it.

It was last Thursday when “NBC Nightly News” took to the airwaves with a segment on “the two words that cost Medicare patients thousands:” outpatient observation.

Yes, a general, mass media outlet finally took notice of what many in healthcare have been bristling about for quite a while, namely hospitals' over-use of the “observation stay” designation. It will never be looked at the same way by millions who saw the NBC report. And while the influence of the traditional Big Three television networks has undeniably waned in recent years, don't kid yourself: They still pack a wallop.

NBC's “warning for everyone on Medicare” is liable to do more than many past McKnight's stories or the massive lobbying efforts of groups like the American Health Care Association ever will. It could be a great step toward ending terrible abuse of current policy.

Patients are — often unknowingly — kept in a hospital under observation outpatient status. They then don't accrue needed inpatient time needed to qualify for Medicare coverage for subsequent skilled nursing care. This “observation” time, which can last for many days, has wrongly cost beneficiaries millions of dollars. (And by extension, kept untold dollars out of long-term care providers' operations.)

But there is hope that NBC's broadcast has struck a match that will lead to a bonfire of attention — and change. Perhaps pending legislation aimed at fixing the mess (there are several proposals out there) will get new legs out of this.

“At long last, it seems that this complex issue is getting attention outside of the D.C. political sphere,” said AHCA President and CEO Mark Parkinson after the broadcast.

One can only hope so.

James M. Berklan is Editor at McKnight's.

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