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Difference between "acute" and "chronic". One of our elder family members had a stroke. Refused at times to do the rigorous physical therapy at the skilled nursing facility aka "rehab", which was the preparation for successfully returning home. The nurses threatened to get the elder expelled from rehab facility if not cooperating, due to rules around improvement. Medicare won't pay for skilled nursing for chronic conditions that are diagnosed as not able to improve with skilled nursing care. Thus the need for long term care insurance, but that's another thread.
Also, magically got all done within the 20 days that Medicare pays 100%. Even with Plan F Medicare supplement, still under 20 days. Almost a design feature of the facility, it occurred to me.
Medicare stops paying on their 100 allowed days of skilled nursing if they can't document "acute"--likely to improve with specific plan of care, vs. "chronic" needs some medical care but won't improve.
As long as Medicare pays more overall for the more ill patients, there can be money in specialized up front treatment through HMO's that targets keeping their care costs down without compromising their longevity. Those specialized care centers are being held up as models of healthcare delivery going forward.
I sound like a cheerleader, and there are criticisms, but I have had the instinct for several years now that the way to "free ourselves" from higher healthcare costs is to put on our grown up pants and use health measures to stay away more, on average, from costly healthcare by, you know, eating better, exercising and quitting tobacco.
"This isn't my idea of fun" playing in the background.
Also, magically got all done within the 20 days that Medicare pays 100%. Even with Plan F Medicare supplement, still under 20 days. Almost a design feature of the facility, it occurred to me.
Medicare stops paying on their 100 allowed days of skilled nursing if they can't document "acute"--likely to improve with specific plan of care, vs. "chronic" needs some medical care but won't improve.
As long as Medicare pays more overall for the more ill patients, there can be money in specialized up front treatment through HMO's that targets keeping their care costs down without compromising their longevity. Those specialized care centers are being held up as models of healthcare delivery going forward.
I sound like a cheerleader, and there are criticisms, but I have had the instinct for several years now that the way to "free ourselves" from higher healthcare costs is to put on our grown up pants and use health measures to stay away more, on average, from costly healthcare by, you know, eating better, exercising and quitting tobacco.
"This isn't my idea of fun" playing in the background.
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