Modest hospitalist cost savings offset by ED visits, readmissions

Despite the touted cost savings of the model, hospitalist care could be taxing Medicare resources, according to a new study published in the Annals of Internal Medicine.

Previous studies and proponents of the care model have long highlighted the cost and care advantages of hospitalists, stating that patients could return home quicker and in better shape.

However, the new study considers the costs after patient discharge. Although hospitalized Medicare patients had a shorter length of stay (0.64 day less), they were more likely to be readmitted to the hospital.  

The cost savings associated with the shortened length of stay were $282 lower on average, but the services after discharge were $332 higher in emergency department visits and readmissions. That totals an extra $1.1 billion in Medicare costs, reports Reuters Health.

"Hospitalists, who typically are employed or subsidized by hospitals, may be more susceptible to behaviors that promote cost shifting," wrote the study authors.

As the fastest growing specialty in America, hospitalists make up 30,000 physicians in the U.S., according to the Society of Hospital Medicine. They practice in 3,300 hospitals and are in 80 percent of hospitals that have more than 200 beds.

"[The study] didn't look at the quality of care," Dr. Joseph Li, president of the Society of Hospital Medicine, told Reuters Health. "It's really hard to look at cost without looking at quality."

For more information:
- read the study abstract
- read the Reuters article
- check out the SHM fact sheet (.pdf)

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