[retiredguy123]

Doctors (and other medical providers) can "opt out" of Medicare altogether and be free to charge whatever they want for their services. But, it is interesting to me, that less than one percent of doctors have decided to do so.

[Bogie Shooter]

Originally Posted by Jazuela

People responding to me are missing the point.

This hospital caters *primarily* to medicare patients. It means this hospital has less money to pay its employees. It means this hospital is less likely to attract top-notch doctors, who typically don't rely *primarily* on medicare to pay their higher salaries, because medicare WILL NOT pay that much. The higher quality doctors will work in environments where they can recoup the loss from low-paying medicare, by having more patients who don't rely on medicare, than they have patients who do.

If you have MOSTLY medicare financing the existence of a hospital, you will have less revenue because medicare does not pay the salaries that attract better quality doctors and staff and faculty.

Most hospitals accept medicare patients, but ALSO have mostly patients who aren't on medicare, whose normal health insurance pays out more. This results in better equipment, better facilities, more staff, higher quality doctors, a better doctor : patient ratio, a better nurse : patient ratio, a higher quality of care score.

The Villages Hospital is dealing PRIMARILY with substandard revenue. You can't expect good service from substandard revenue.

Nowhere did I mention, hint, or even suggest that other hospitals don't accept medicare and are therefore better. Nowhere did I suggest, hint, or imply that hospitals that do accept medicare are substandard.

Again - I was very specific. THIS hospital - that relies PRIMARILY (not exclusively, not equally to any other, but primarily) on medicare to foot the bill - will - because it's medicare primarily footing the bill - attract faculty, staff, physicians, who are willing to accept much lower pay than hospitals that do not rely *primarily* on medicare to foot the bill.

It's basic economics. If you want to prove me wrong, donate $28 million to TVH to improve their staffing and quality of care issues. You'll see a better caliber of staff seeking to work there, and you'll see a higher quality of care.

Where can I read the facts to support these claims??

[billethkid]

Originally Posted by Jazuela

People responding to me are missing the point.

This hospital caters *primarily* to medicare patients. It means this hospital has less money to pay its employees. It means this hospital is less likely to attract top-notch doctors, who typically don't rely *primarily* on medicare to pay their higher salaries, because medicare WILL NOT pay that much. The higher quality doctors will work in environments where they can recoup the loss from low-paying medicare, by having more patients who don't rely on medicare, than they have patients who do.

If you have MOSTLY medicare financing the existence of a hospital, you will have less revenue because medicare does not pay the salaries that attract better quality doctors and staff and faculty.

Most hospitals accept medicare patients, but ALSO have mostly patients who aren't on medicare, whose normal health insurance pays out more. This results in better equipment, better facilities, more staff, higher quality doctors, a better doctor : patient ratio, a better nurse : patient ratio, a higher quality of care score.

The Villages Hospital is dealing PRIMARILY with substandard revenue. You can't expect good service from substandard revenue.

Nowhere did I mention, hint, or even suggest that other hospitals don't accept medicare and are therefore better. Nowhere did I suggest, hint, or imply that hospitals that do accept medicare are substandard.

Again - I was very specific. THIS hospital - that relies PRIMARILY (not exclusively, not equally to any other, but primarily) on medicare to foot the bill - will - because it's medicare primarily footing the bill - attract faculty, staff, physicians, who are willing to accept much lower pay than hospitals that do not rely *primarily* on medicare to foot the bill.

It's basic economics. If you want to prove me wrong, donate $28 million to TVH to improve their staffing and quality of care issues. You'll see a better caliber of staff seeking to work there, and you'll see a higher quality of care.

The fault with this "opinion" is the top notch, best in their field specialists that operate in these so called medicare primarily hospitals are no less because of the hospitals where they practice.
Hence the premise is flawed.

[OrangeBlossomBaby]

Same place I found them. Google.
From THE VILLAGES REGIONAL HOSPITAL COMMUNITY HEALTH STATUS ASSESSMENT - https://wellflorida.org/wp-content/u...5-2016-pdf.pdf

Medicare as the payor source covered the greatest percent of discharges and patient days in both 2013
(76.7% and 78.5%, respectively) and 2014 (76.5% and 78.5%, respectively). Private Insurance as the payor
source was the next greatest percentage of discharges and patient days in both 2013 (10.3% and 9.3%,
respectively) and 2014 (10.8% and 9.9%, respectively) (Table 174, Technical Appendix). From 2013 to
2014, while Medicare as the payor source decreased, Medicaid and private insurance as the payor increased;
this trend for TVRH Service Area is similar to the CFH Service Area and the state of Florida (Table 174,
Technical Appendix).

I also found some of the data at the American Hospital Directory, gleaned a few tidbits from a US News report, and a smattering of random other medical, insurance, and government websites through the search.

[vintageogauge]

Originally Posted by Jazuela

You can basically blame Medicare for that. Medicare is known to pay far less than any health insurance. Quality begets quality. Offer greater pay, you'll attract greater faculty and staff. If the best you can do is a 90% Medicare payout, then you'll get the bottom 10% of the quality care in return.

The Cleveland Clinic accepts Medicare and Medicaid, they do a pretty good job in all of their hospitals. That is the only system I used for 40 years and can still go back if I had to.

[vintageogauge]

Originally Posted by Jazuela

People responding to me are missing the point.

This hospital caters *primarily* to medicare patients. It means this hospital has less money to pay its employees. It means this hospital is less likely to attract top-notch doctors, who typically don't rely *primarily* on medicare to pay their higher salaries, because medicare WILL NOT pay that much. The higher quality doctors will work in environments where they can recoup the loss from low-paying medicare, by having more patients who don't rely on medicare, than they have patients who do.

If you have MOSTLY medicare financing the existence of a hospital, you will have less revenue because medicare does not pay the salaries that attract better quality doctors and staff and faculty.

Most hospitals accept medicare patients, but ALSO have mostly patients who aren't on medicare, whose normal health insurance pays out more. This results in better equipment, better facilities, more staff, higher quality doctors, a better doctor : patient ratio, a better nurse : patient ratio, a higher quality of care score.

The Villages Hospital is dealing PRIMARILY with substandard revenue. You can't expect good service from substandard revenue.

Nowhere did I mention, hint, or even suggest that other hospitals don't accept medicare and are therefore better. Nowhere did I suggest, hint, or imply that hospitals that do accept medicare are substandard.

Again - I was very specific. THIS hospital - that relies PRIMARILY (not exclusively, not equally to any other, but primarily) on medicare to foot the bill - will - because it's medicare primarily footing the bill - attract faculty, staff, physicians, who are willing to accept much lower pay than hospitals that do not rely *primarily* on medicare to foot the bill.

It's basic economics. If you want to prove me wrong, donate $28 million to TVH to improve their staffing and quality of care issues. You'll see a better caliber of staff seeking to work there, and you'll see a higher quality of care.

I wonder how a geriatric specialist makes a decent living as all of his patients are most likely on Medicare.

[retiredguy123]

Originally Posted by vintageogauge

I wonder how a geriatric specialist makes a decent living as all of his patients are most likely on Medicare.

I agree. I don't even think that it is legal to sell private health insurance to someone over 65. So, if the geriatric specialist doesn't accept Medicare, their patients would need to pay the entire fees out of pocket.

[Nucky]

Originally Posted by refeik

It is so sad that the Villages Hospital has continued to fall by the CMS ratings. In 2017 it was rated at a 3, now it is rated at a disappointing 1.

I see from your post that the rating has fallen. I also saw an advertisement lately in the paper that the higher muckety mucks at the hospital were touting their rating going up in some category. I'm sorry that I'm speaking in general terms without the link to prove what I'm typing.

I just spent some time going thru Golfing Eagles & dbussones old posts and see how their explanation about any issue was handled much easier than any of us could ever hope to do.

With all their years in the Medical Business, their explanations were beautiful and very soothing. To have people like that who gave so much time to help people like Barney Rubble & Wilma Flintstone understand the inner workings and the thought process of the messed up Medical world and to put it into terms that everyone could understand was priceless.

Unfortunately, our Dear friend GE had to face the biggest loss a person could go thru with the death of his spouse. We kept in touch for a while and he is Golfing all over the place and just trying to get his head back on. He was married to his beloved wife for a long time. Who knows maybe one day we will be lucky enough to get him back. I truly cherish his counseling and time he and others put in on the Forum and behind the scenes to get us to Florida.

I'm going to take a guess that our other Dear friend dbussone was just fed up of the abuse that he received from some of the tough Beer Muscled Posters that criticized every post and I believe he thinks he got an unfair shake from one of the people (no actual proof) who policed the forum back then. That person has obviously been relieved of his or her duties. Please accept that as constructive criticism because I think it was the reason he took a powder. What a loss that was also.

We pretty much had the answer to all medical questions at our fingertips and life and the old ways of this Forum cost us two extra valuable and giving fantastic human lima beings and loving people who did a whole lot for people that was without any praise of fanfare.

They had contacts at the top of the food chain at our Hospital and made many Constructive Suggestions based on things they read here when regular people were struggling to digest information that they think they have read properly. These two men would operate on any post or link or report marked 2015 and would tell us what it really meant.

The way I called them when we were Goofing around on The Three Word Sentence Thread may work so I'll give it a shot and let's see if it works!

Car 54'S Would You Please Report for duty we Flintstoner's need a real interpretation of some things we've read.

Go back and scan both of these guys posts from 2017 and you'll see what I mean about their way of explaining different medical situations with total goodwill. Bless them both I hope life is treating them well.

[dblwyr]

Medicare is an important payer to hospitals. Note these statistics—that While dated, are relevant as these number are usually lagging. “The majority of patients treated by hospitals are covered by Medicare (40.9 percent of patients treated in U.S. hospitals). The average payer mix of a U.S. hospital is as follows: Medicare: 40.9 percent. Medicaid: 17.2 percent. (Becker;s, 2013). Medicare revenue is key to hospital revenues. Payment formulas and contractual agreements are complex, and thus what might look like hospital costs are not necessarily related to revenue. My point is, Medicare patient population does not mean less revenue and poor care.

[OrangeBlossomBaby]

Originally Posted by dblwyr

Medicare is an important payer to hospitals. Note these statistics—that While dated, are relevant as these number are usually lagging. “The majority of patients treated by hospitals are covered by Medicare (40.9 percent of patients treated in U.S. hospitals). The average payer mix of a U.S. hospital is as follows: Medicare: 40.9 percent. Medicaid: 17.2 percent. (Becker;s, 2013). Medicare revenue is key to hospital revenues. Payment formulas and contractual agreements are complex, and thus what might look like hospital costs are not necessarily related to revenue. My point is, Medicare patient population does not mean less revenue and poor care.

Medicare is guaranteed to the hospital, but it is contractually less than non-medicare payment. Hospitals and doctors lose money from medicare. They make up for it by charging higher prices and fees to the private sector. The more medicare and less private sector, the less the hospital and doctor will make.

This is a fact. It is a known fact, it's been a fact for years and years and years. Anyone who has ever worked in hospital finance, accounts receivable, accounts payable, billing, insurance claim, or anything similar in a medical setting, can tell you this.

Hospitals typically receive medicare payments from around 40% of its patient base, as you said. But while these payments are guaranteed, they are also LESS than the actual cost of the services they're supposed to be covering.

[Carla B]

It is the opinion of my daughter, who has worked in collecting claims for certain hospitals from health insurers for the past 19 years, that without Medicare as a payer many hospitals would have to close their doors. Medicare pays on time. The worst payer she has dealt with is Aetna.

[simpilot]

Based on my cousins recent stay one star was too many. No response to call button, missed medication, missed meals, ...

[WILDORCHID]

Originally Posted by Bambi

You were lucky. Federal agency (MedicareJ has rated our hospital as substandard not only in several areas but overall. POA is having the CEO explain at the next meeting on the 20th.

Believe me the CEO is the problem and he will never prepare going to a meeting alone. He'll always take his VP'S and related management with him and throw them under the bus. For the money this guy makes it's amazing that the organization has not looked into his overall performance.

[Boomer]

I am reading recently about proposed cuts to Medicare and to Social Security and also Medicaid. Of course, the fraud needs to be cleaned up but this would go beyond that.

Please pay attention. Read and listen — widely and wisely — to stay informed on these proposed cuts that could affect you and yours directly.

I hope this does not get pulled because somebody thinks I am being partisan. I am just saying to be aware. This is about us.

Cassandra Boomer

[graciegirl]

Originally Posted by Boomer

I am reading recently about proposed cuts to Medicare and to Social Security and also Medicaid. Of course, the fraud needs to be cleaned up but this would go beyond that.

Please pay attention. Read and listen — widely and wisely — to stay informed on these proposed cuts that could affect you and yours directly.

I hope this does not get pulled because somebody thinks I am being partisan. I am just saying to be aware. This is about us.

Cassandra Boomer

I have read about these proposed changes and just like all seniors I am concerned, but after having read the proposed changes, it appears that there will be concentration on those posing as disabled and other people who are abusing the system.