As managed-care companies ease restrictions on certain hospital procedures and treatments, Illinois patients are staying a bit longer in the hospital, a new analysis indicates.
For the first time in at least a decade, the average length of a patient’s stay in an Illinois hospital increased, rising to 4.9 days in 2001 from 4.8 days in 2000, according to the 2003 American Hospital Association hospital statistics guide.
The study provides statistical evidence bolstering recent arguments of hospitals that have complained that government reductions in spending are hurting them at a time they are seeing more patients for longer periods. Hospitals also say they are seeing more uninsured patients in their emergency rooms.
Although it was just a slight increase, the shift is in contrast to the flat or falling inpatient stays of the 1990s. During that period, developments in managed care and medical technology greatly reduced the amount of time patients stayed in the hospital.
Yet the political winds these days favor more mandates for insurers to allow patients to stay longer in the hospital. Health plans like HMOs, which are the most restrictive in allowing choices of doctors and hospitals, have been ceding more control to hospitals, analysts say.
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More consumers are moving away from HMOs to preferred provider organizations, or PPOs, which don’t require their subscribers to get a doctor’s approval before seeing a specialist. Thus, PPOs make it easier to get care in more specialized hospital settings.
“The shift of more people to PPOs has driven some of the utilization,” said Todd Swim, an analyst with Mercer Human Resource Consulting in Chicago. “Managed-care plans have dropped back from some of the utilization control procedures. We have taken a bit of the `management’ word out of `managed care.'”
Nationally, however, inpatient utilization continued to drop. The average length of stay for U.S. community hospitals fell to 5.1 days in 2001 from 5.2 days in 2000, the Chicago-based American Hospital Association said.
Analysts, however, attribute the difference between national and local inpatient trends to the lack of clout HMOs have in the Chicago market, where PPOs are the dominant form of health insurance. They expect inpatient hospital stays could eventually rise elsewhere.
Coalition chief to step back: James Mortimer, the founder and longtime president of the Midwest Business Group of Health, will begin a partial retirement in 2003.
Mortimer, 59, who has been the Chicago-based group’s president for nearly 23 years, has been key in raising the organization’s profile in recent years.
Midwest Business Group is a coalition of about 70 employers in 11 states that works to help its members in their health-care purchasing decisions. Lately, the group has stepped up efforts to measure the quality of doctors and hospitals so employers can know they are receiving good medical care for the higher price they are paying.
Mortimer will be replaced by Dr. Dennis Richling, who will take on the organization’s top job in February. Richling is assistant vice president of health services of Union Pacific Railroad in Omaha.
Mortimer will continue to work part time for Midwest Business Group as executive vice president in charge of the organization’s health-care purchasing project.