Posted on 05/15/2007 7:52:12 PM PDT by Zakeet
LOS ANGELES - More than a year after an elderly hospital patient was found wandering a crime-ridden area in a hospital gown and slippers, the nation's largest HMO agreed in a settlement with the city to changes aimed at ending the dumping of homeless patients on streets.
Kaiser Permanente will create new protocols for discharging homeless patients in its chain of hospitals, train staff and allow a retired U.S. district judge to monitor its progress, officials said Tuesday.
Carol Ann Reyes, 64, was discharged from Kaiser's Bellflower hospital in March 2006 and dropped off by a taxi outside the Union Rescue Mission in the city's notorious Skid Row area. She wandered around, apparently confused, for several minutes until mission staff took her in.
City Attorney Rocky Delgadillo filed charges in November and said he wanted to send a message to hospitals nationwide that engage in patient dumping. Los Angeles authorities are investigating allegations that a dozen area hospitals have dumped more than 50 homeless patients downtown.
Kaiser faced false imprisonment charges and civil claims related to the mistreatment of Reyes.
As part of the settlement, Kaiser will pay $5,000 in civil penalties, $50,000 in investigative costs to the city attorney's office and contribute $500,000 to a charitable foundation benefiting local homeless programs.
Kaiser previously denied any wrongdoing.
(Excerpt) Read more at news.yahoo.com ...
What solutions would you recommend?
“From many” asks a valid question. What should hospitals do with vagrants who apparently aren’t all that sick and who can’t pay for treatment?
That's not gonna look good on somebody's resume at the Pearly Gates.
L.A. is a liberal mecca, why didn’t some of them help out?
Hospitals and HMOs are not allowed to "dump" patients. They are permitted to discharge patients only after the individuals are able to care for themselves, or have someone to care for them.
There are many programs, both public and private, which assist indigent persons who need some form of assisted care. Hospitals and HMOs are well aware of those options and they know how to make good use of them.
HMOs are notorious for patient dumping. Inside the industry, the practice is known as "surfing" and "turfing." The latter term refers to making life so miserable for the chronically ill [i.e. by grinding them into the turf] that they go elsewhere for their medical care reimbursement. The former term refers to the observation that things are so bad for the chronically ill that they frequently change physicians, medical practices, hospitals and insurers [i.e. they surf].
HMO customers pay the HMO a fixed price per person per month. The HMO in return promises to pay for all the medical care the individual needs. If a patient is healthy, the HMO earns a profit. If a patient needs expensive medical care, the HMO will lose money and thus has a strong incentive to get rid of the individual.
Given the age of the patient in the article and her lack of income, it is reasonable to assume that she was covered under a government sponsored plan. It therefore appears that the HMO was trying to take the government's money without rendering promised service - another improper act.
Your information is interesting, but I don’t see a solution.
HMOs are businesses and are supposed to make a profit for their shareholders. Charities are not businesses and are under no obligation to help HMOs to keep their profits high. Private physicians also need a reasonable expectation of a decent return on their years of investment in education and low paid training or they either won’t enter the profession or will leave early.
I see attitudinizing on all sides of this debate. I don’t see many potentially useful solutions coming from conservatives. Without that, guess what will happen?
My one and only fixed position is that, because of the bioterror potential, air/water/food borne infectious illnesses need to be covered in the defense budget and not skimped on.
In my opinion, the solution lies in HMOs honoring their contractual and legal obligations.
HMOs purportedly adjust their rates upward to the point where they can provide for the medical expenses of their customers and generate a fair profit for their owners. Their rates are supposedly kept in balance by their competition - other HMOs and other managed care enterprises.
The problems presented in the article and elsewhere are caused when HMOs cheat by dumping patients and otherwise take their customers' money without providing services. The means of solving to these problems is to stop the fraud and deception.
What would be a responsible way oif dealing with a homeless person who is ill, but not ill enough to be in the hospital?
The HMO has every right to stop paying once the patient no longer needs hospitalization.
Wrong!
HMOs supposedly pay for much more than hospitalization. Depending on their contract, they are responsible for physician fees, medicines, imaging, labs, medical devices, etc.
In fact, one of the biggest selling points of HMOs to employers is their promise to pay for more of the routine health care costs and thus encourage employees to seek care sooner rather than later while their condition is either preventable, or can be treated at a lower cost with less time off work.
The HMO only has the right to stop paying once the patient no longer needs medical care.
You are correct.
I should have been much clearer.
The HMO can stop paying for hospital care once the patient no longer has a medical condition requiring hospital care.
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