Emergency room stays can cost a bundle

How can you keep costs down?

By Matilda Charles
| 2:41 p.m. December 4, 2013

Winter Park - Maitland Observer
Neighborhood

The length of time you might spend in the emergency room has gotten longer — and longer — as many Medicare patients are held under what’s called “observation status.

AARP recently completed a study called “Rapid Growth in Medicare Hospital Observation Services: What’s Going On?” that shows the length of time patients are held that way has grown, sometimes to more than 48 hours.

If you’re a Medicare patient, you can be toting up out-of-pocket costs with every passing hour you’re held in this medical limbo. There’s no cost-sharing cap with these observation status stays, not to mention that you might not receive the level of care that you should. As an observation outpatient, you’re liable for the costs of tests and procedures.

Additionally, if you end up in skilled nursing, the observation status time you spend in the hospital doesn’t count for the Medicare requirement that you have three days as an inpatient. Your portion of the costs can skyrocket, and you might even be denied skilled nursing care because you weren’t in the hospital long enough as an official inpatient.

Here are some specifics from the AARP study:

• Observation status stays have increased 94 percent.

• Patient status (observation versus inpatient) is sometimes changed by the hospital after the patient is sent home.

• The average cost for skilled nursing that Medicare didn’t cover (due to being originally held in observation limbo) was $10,503.

A number of senators in Congress have proposed legislation that would require time spent in observation status to count as part of the three-day inpatient requirement.

To read the full 25-page report, go to aarp.org and put the study’s title in the search box.