[PattonD]

I am trying to find out why a hospital can charge more for L&D services if they have their own building seperate from the main hospital. Something medicare something .....someone help me out here.



Hypothetical "what if" scenerio....

I am picturing a pregnant woman (not on medicare) that has been injured and the ambulance not knowing which building to take her. They take her to L&D but the baby is ok, but mom could have used the extra time wasted in transport to L&D so she ends up dying because of a stupid hospital policy that all pregnant women go to L&D first.

Somethin ain't right with that picture.

[widi96]

Our L&D is in a different building, but connected by a large hallway that runs above the road.

Our policy is that if a pregnant trauma comes in - if their complaints don't have anything to do with the baby - they are stabilized in the ER, sent to OB, then back to the ER. If they are having abdominal pain or bleeding after trauma - OB sends their equipment and two nurses to assist the ER staff in immediate care. It all has worked out really well. The only potential problem we have with it being in a different building is that if they would ever have a code over there - I hope those nurses REALLY know what they are doing, because by the time the code team could get there, it would probably be too late.

[LNDis4ME]

Originally Posted by PattonD

I am trying to find out why a hospital can charge more for L&D services if they have their own building seperate from the main hospital. Something medicare something .....someone help me out here.



Hypothetical "what if" scenerio....

I am picturing a pregnant woman (not on medicare) that has been injured and the ambulance not knowing which building to take her. They take her to L&D but the baby is ok, but mom could have used the extra time wasted in transport to L&D so she ends up dying because of a stupid hospital policy that all pregnant women go to L&D first.

Somethin ain't right with that picture.

I'm sorry that I don't know the answer to your question, but did you mean MEDICAID? Medicare is for the elderly and/or severely disabled. I just wanted to clarify.....

As far as your question goes, the only thing I can think of is that the hospital may be able to bill MEDICAID at a higher rate if the L&D is considered a "stand alone birth center"? I'm grasping at straws here, but it's a thought.

[Jolie]

Hospitals can charge anything they like for L&D services, the reality is that Medicaid (not Medicare) will pay only a set amount per delivery. I am not aware that they pay more for births in freestanding units than hospital-based ones.

I used to work in a unit that was physically separate from the main hospital, connected only by a loonngg corridor. The entrance to the Birthing Center and parking for staff, patients, and families were also separate from the main entrance to the hospital. It was intended to create the "illusion" of a free-standing birth center, as opposed to a high-intervention hospital unit. It also provided a measure of security, as no one other than our patients' visitors had any reason to be present in our little corner of the world. It was a nice, somewhat private set-up.

As for the risk of a patient being brought to ER instead of L&D (or vice versa), it really wasn't an issue. We were strictly a low-risk center, so no trauma patients would have been brought to our hospital anyway. EMS would have taken them to other facilities, and the patients who were delivering with us knew where to come.

[Tampagirl]

Hospitals and MD's have a contract with Medicaid and any other insurance that they accept on how much they will be paid for certain procedures. Medicare and Medicaid pay the most and the insurance companies will usually contract 80-90% of that amount. The facilities have contract negotiations with the insurance companies to get the most money. If they don't like it they don't accept the insurance (which sometimes means that they are actually paid more because they are taking care of someone who is "out of network").

As for the emergency situation whether it is a walk in or ambulance the hospital that is near me goes like this less than 24 weeks regular ER 24 weeks and over Womens Hospital (L&D) ER.

[PattonD]

I think medicaid pays one flat fee whether the patient is in for one day or 10 days. In a free standing building they can be charged for all 10 days,....something to that effect.