37323 Inpatient vs. Observation Hospital Status

Course overview

Discussion about inpatient vs. observation hospital status. Topics include the differences between the three types of hospital visits; how observation status impacts insurance reimbursement to hospitals; how observation status and inpatient status can impact the patient financially; and the benefits of both inpatient and observation status. There is also a discussion about how implicit bias may impact healthcare. Observation care is described by the Medicare program as a well-defined set of clinically appropriate services that includes short-term treatment, assessment, and reassessment before a decision can be made as to whether a patient can be discharged, or requires further treatment as an inpatient. The care that patients receive when admitted under observation is frequently indistinguishable from inpatient care. However, the financial burden of inappropriate status assignment for hospitals and patients can be large. Patients may not be aware that they are under observation, or that this designation significantly impacts coverage, payment, and cost-sharing expenses under the Medicare program. Healthcare providers need to be educated regarding inpatient versus observation care to ensure that the appropriate designation is utilized to optimize patient outcomes.