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Hospitals hoping time runs out on midnight rule
SLAM DUNK
For some Medicare patients, sitting in a hospital bed overnight doesn’t necessarily mean they’ve been admitted. Consider it the Medicare version of purgatory, and it’s confusing patients and taking a chunk out of local hospitals’ bottom lines. Last year, the cash-strapped Medicare program instituted a rule that stated that patients needed two nights — make that two midnights — in the hospital to qualify for inpatient-hospital rates. If they don’t cross that two-midnight threshold, hospitals must bill at the lower, outpatient rates. Basically, it injects a time element into a doctor’s decision of whether to admit a patient, and hospitals are clamoring for a change. “It is so convoluted now and under such fire they’ll have to do something to change it,” said Don Paulson, University Hospitals’ vice president of revenue cycle management. The rule, according to Moody’s Investors Service, has the potential to cost hospitals $3,000 to $4,000 per case. That’s big bucks, considering about 40% to 50% of most hospitals’ patients are Medicare beneficiaries. Moreover, Medicare patients are likely on the hook for more of the bill — co-pays and drug expenses, for instance — when the hospitals are reimbursed at the outpatient rates. A boon in high-deductible health plans already has forced hospitals to up their game in collecting unpaid bills, and the two-midnight rule would only intensify those efforts among See MIDNIGHT, page 24
CAVS’ ‘ALL OHIO’ APPROACH GAINS CRUCIAL MOMENTUM
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By TIMOTHY MAGAW tmagaw@crain.com
STORY BY KEVIN KLEPS n 30-second television commercials, the likes of Urban Iproclaim Meyer, Archie Griffin, Thad Matta and Clark Kellogg themselves Cleveland Cavaliers.
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AN ILLUSTRATED LIST, P. 22-23
See CAVALIERS, page 26
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For the Cavs, captivating the attention of Columbus, Cincinnati and other markets outside Northeast Ohio has been a process that’s more than a decade old. Only now — with the return of LeBron James, the acquisition of Kevin Love and the focus of much of the NBA on Cleveland — the Cavs are playing from a position of strength. Kerry Bubolz, president of business operations for the Cavs, said the team, as the only NBA franchise in the Buckeye State, has “always felt like we should own Ohio.” Following an offseason in which every conceivable
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