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(New York Times)

To the Editor:

Today’s story, The Hidden Financial Incentives Behind Your Shorter Hospital Stay, describes how hospital stays classified under “Observation Status” are skewing admission and readmission data. As Dr. Jha states in the article, Observation Status is driven by incentives for the hospital.  This is an ever-increasing phenomena in which Medicare deems patients as “outpatients,” although they are in the hospitals for days.

The Center for Medicare Advocacy has worked for many years to end the harm that Observation Status causes people who rely on Medicare.  We have helped hundreds of beneficiaries and families, assembled a broad national coalition to support legislation to fix the problem, and filed lawsuits on behalf of elderly patients.

"Outpatient" hospital observation status limits access to necessary post-hospital nursing home care, alters public health data regarding hospital admissions and readmissions, increases Part B costs and cost-sharing, and creates lengthy delays in the Medicare appeals system. With all this harm, one must ask: Why does the Centers for Medicare & Medicaid Services insist on continuing this dreadful policy? 

Judith Stein
Executive Director
Center for Medicare Advocacy, Inc.

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