Fact check: Hospitals get paid more if patients listed as COVID-19, on ventilators
Earlier today, I was checking out articles on the internet before coming to WS
I saw some posts and I added a reply because I just read an article on death certificates.
My apologies @musicaljoke, my post was not directed to you. I should have made my own post and not add it on to what you said. I came back to tell you the outcome of the article.
It seems many on the internet were talking about this interview, enough where it was fact checked.
I came on to add this new article I read to my post, but it was deleted. Not an approved source
"Jensen said, "Hospital administrators might well want to see COVID-19 attached to a discharge summary or a death certificate. Why? Because if it's a straightforward, garden-variety pneumonia that a person is admitted to the hospital for – if they're Medicare – typically, the diagnosis-related group lump sum payment would be $5,000. But if it's COVID-19 pneumonia, then it's $13,000, and if that COVID-19 pneumonia patient ends up on a ventilator, it goes up to $39,000."
Jensen clarified in the video that he doesn't think physicians are "gaming the system" so much as other "players," such as hospital administrators, who he said may pressure physicians to cite all diagnoses, including "probable" COVID-19, on discharge papers or death certificates to get the higher Medicare allocation allowed under the Coronavirus Aid, Relief and Economic Security Act. Past practice, Jensen said, did not include probabilities.
Provision in the relief act
The coronavirus relief legislation created a 20% premium, or add-on, for COVID-19 Medicare patients.
There have been no public reports that hospitals are exaggerating COVID-19 numbers to receive higher Medicare payments.
How does Medicare pay?
Snopes investigated the claim, finding it's plausible Medicare pays in the range Jensen mentions but doesn't have a "one-size-fits-all" payment to hospitals for COVID-19 patients.
Our ruling: True
We rate the claim that hospitals get paid more if patients are listed as COVID-19 and on ventilators as TRUE.
Hospitals and doctors do get paid more for Medicare patients diagnosed with COVID-19 or if it's considered presumed they have COVID-19 absent a laboratory-confirmed test, and three times more if the patients are placed on a ventilator to cover the cost of care and loss of business resulting from a shift in focus to treat COVID-19 cases.
This higher allocation of funds has been made possible under the Coronavirus Aid, Relief and Economic Security Act through a Medicare 20% add-on to its regular payment for COVID-19 patients, as verified by USA TODAY through the American Hospital Association Special Bulletin on the topic.
Our fact-check sources
Fact check: Medicare pays hospitals more money for COVID-19 patients
Earlier today, I was checking out articles on the internet before coming to WS
I saw some posts and I added a reply because I just read an article on death certificates.
My apologies @musicaljoke, my post was not directed to you. I should have made my own post and not add it on to what you said. I came back to tell you the outcome of the article.
It seems many on the internet were talking about this interview, enough where it was fact checked.
I came on to add this new article I read to my post, but it was deleted. Not an approved source
"Jensen said, "Hospital administrators might well want to see COVID-19 attached to a discharge summary or a death certificate. Why? Because if it's a straightforward, garden-variety pneumonia that a person is admitted to the hospital for – if they're Medicare – typically, the diagnosis-related group lump sum payment would be $5,000. But if it's COVID-19 pneumonia, then it's $13,000, and if that COVID-19 pneumonia patient ends up on a ventilator, it goes up to $39,000."
Jensen clarified in the video that he doesn't think physicians are "gaming the system" so much as other "players," such as hospital administrators, who he said may pressure physicians to cite all diagnoses, including "probable" COVID-19, on discharge papers or death certificates to get the higher Medicare allocation allowed under the Coronavirus Aid, Relief and Economic Security Act. Past practice, Jensen said, did not include probabilities.
Provision in the relief act
The coronavirus relief legislation created a 20% premium, or add-on, for COVID-19 Medicare patients.
There have been no public reports that hospitals are exaggerating COVID-19 numbers to receive higher Medicare payments.
How does Medicare pay?
Snopes investigated the claim, finding it's plausible Medicare pays in the range Jensen mentions but doesn't have a "one-size-fits-all" payment to hospitals for COVID-19 patients.
Our ruling: True
We rate the claim that hospitals get paid more if patients are listed as COVID-19 and on ventilators as TRUE.
Hospitals and doctors do get paid more for Medicare patients diagnosed with COVID-19 or if it's considered presumed they have COVID-19 absent a laboratory-confirmed test, and three times more if the patients are placed on a ventilator to cover the cost of care and loss of business resulting from a shift in focus to treat COVID-19 cases.
This higher allocation of funds has been made possible under the Coronavirus Aid, Relief and Economic Security Act through a Medicare 20% add-on to its regular payment for COVID-19 patients, as verified by USA TODAY through the American Hospital Association Special Bulletin on the topic.
Our fact-check sources
- The Spectator: "Hospitals get more to list patients as COVID-19 and three times as much if the patient goes on ventilator"
- The World Net Daily: "Hospitals get paid more to list patients as COVID-19"
- Snopes: "Is Medicare paying hospitals $13K for patients diagnosed with COVID-19, $39K for those on ventilators
- PolitiFact: "Hospitals get paid more to list patients as COVID-19"
- Kaiser Health News: "Estimated cost for treating the uninsured hospitalized with COVID-19"
- Factcheck.org: "Hospital Payments and the COVID-19 Death Count"
- Coronavirus Aid, Relief and Economic Security Act
- U.S. Department of Health and Human Services: "Guidance for Certifying Death Due to COVID-19"
- Verywellhealth.com: "How a DRG determines how much a hospital gets paid"
- American Hospital Association Special Bulletin
- American Hospital Association special bulletin.
- Email response from Marty Makary, a surgeon and professor of health policy and management at Johns Hopkins Bloomberg School of Public Health.
Fact check: Medicare pays hospitals more money for COVID-19 patients