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Few understand that hospitals are paid by Medicare according to DRG coding. See link:
https://www.verywellhealth.com/how-does-a-drg-determine-how-much-a-hospital-gets-paid-1738874
So think--for instance: Mom goes in with pneumonia. She is 84 years old. She is allotted the same number of days as the 24-year-old with same diagnosis. However, Mom is unlikely to leave in the allotted time, whereas the 24-year-old may exit the next day.
This complicates services.
Say 3 days are allotted for "pneumonia" code. Mom stays 7, but the 24-year-old is out in 1 day. This means the hospital LOSES money on Mom and gains money on Junior.
This incentive is part of the reason hospitals send people home before they are ready.
This incentive is one of the reasons hospitals add on codes such as "arthritis flare", "dementia" and etc. to try to get more days added.



But one of the complications of our medical system.

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Unfortunately, this coding to get paid more, is also why our medical records aren't an accurate picture. This BS practice causes increases in insurance premiums for the individual being miscoded to get greater compensation.

I wish that billing was fair and honest, then we wouldn't have to have a system that games are played to get fair and honest payment.

So screwed up!
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Interesting. I know when Mom was in for a UTI she went in on a Tues., doing well on Wed when doctor examined her and discharged her. Thur went in and she was out of it breathing weird and everytime I went out to the Nurses station I was told she was discharged and she was going to Rehab. I was saying she did a 180. I knew Rehab would send her back. They finally got hold of the Dr. (which I persisted they call) he allowed one more day saying they would check out a nodule in her neck. Daughter showed up and found the antibiotic had penicillin in it which Mom was, according to hospital records, was allergic to.
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