Obamacare Confusion Sends Hospital Admissions To Lowest On Record

Tyler Durden's picture

Only 5% of hospitals in American saw year-over-year growth in overall admissions in November, according to Citi. This is the weakest inpatient admission rate on record and comes amid both doctor and patient uncertainty over the Obamacare changes. As Citi's Gary Taylor notes "the paralyzing effect of the impotent Obamacare rollout" and Medicare's new "two-midnight" rule will weigh notably on hospital earnings as doctor's employment and compensation modesl remain in flux. 13 days to go...

Citi's survey drops to record low...

Only 5% of responders cited yty growth in overall admissions. This result is the weakest in the 11-year history of our survey and compares to a revised 22% in October, 37% in September and 24% in August.


And the survey has tended to be predictive of reality...


Via Reuters,



New billing rules for the Medicare program for the elderly and disabled require hospitals to treat patient stays lasting less than "two midnights" as an outpatient visit.


"In addition, it is reasonable to conclude that the cumulative impact of changing physician employment and payment models is beginning to play a role, as well as the paralyzing effect of the impotent Obamacare rollout," Citi analyst Gary Taylor said in a report.


Hospital inpatient admissions in November fell to their weakest level in more than a decade, based on responses to the bank's monthly survey of 98 hospitals, Taylor said.


In October and November combined, admissions were down 4 to 5 percent from a year ago, which will likely weigh on hospital operators' fourth-quarter earnings and 2014 forecasts, he said.

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Smuckers's picture

Ocomacare at work for you.

SafelyGraze's picture

"Hospital Admissions Lowest On Record"

this is *great* news!!!

the article completely mischaracterizes the reality!

low admissions are merely one of the many indicators that People Are Getting Healthier And Weller because of the new laws

please do your part to keep hospital admissions low by 

- eating your vegetables

- saying no to drugs

- exercising (under the supervision of your doctor)

- taking your prescription medications

- limiting high-risk behaviors

thank you and xappy xolidays!



AlaricBalth's picture

It's a miracle! Maybe this Messiah thing is true!
(Must I really put sarc?)

Miffed Microbiologist's picture

Too funny. Hospitals face no reembursement from Medicare if a Medicare patient is readmitted to the hospital in a short time. May be hospitals figure if they don't admit them in the first place they avoid this issue. Win win all around! Perhaps this is a good time to be in the mortuary business.


suteibu's picture

I'm surprised hospitals haven't expanded into the mortuary business...on site.  One stop shopping.  Turnkey healthcare.  Cradle-to-grave care. The marketing writes itself.

Miffed Microbiologist's picture

And considering the number of hospital admissions due to drug side effects in patients who used pharmaceuticals PROPERLY as prescribed. When you add in the improperly used drugs plus the drug-drug interactions, you have a number in the 100s of thousands. How many legitimate businesses can actually create there own income steam? Play at your own risk. And this is coming from someone in the belly of the beast.


johngaltfla's picture

I would have checked in until I realized I don't have coverage for perpetual barfing due to this ad.....FWIW, check out the "suttle" hing in the window above the door of the gingerbread house. If thisn't homopropaganada 101, I don't know what is...


WARNING: HEALTHCARE.gov Video Advertisement that will make you Vomit

suteibu's picture

You should ban yourself for putting that link on here.  It is, indeed, vomit inducing.

GetZeeGold's picture



You should ban yourself


I'm sure he'll get around to it......when he freakin feels like it.

ReallySparky's picture

Just wow! John did you notice the guy on far right with military dog tags. Disgusting waste of taxpayer dollars. Unbelievable!

Miffed Microbiologist's picture

Well, that video cinched it for me. I'm applying for the one way trip to Mars. This country needs complete flushing and that right soon. Im afraid that gingerbread house image will be still be fresh in my mind as I'm drooling in the corner in the nursing home.


Falling Down's picture

Using homoeroticism to sell ObammyCare.



mess nonster's picture

What would Phil Robertson do?

GetZeeGold's picture



Probably pull the plunger on A-E........and watch them look stupid?


When you've got 400 million in the bank what would you do?

jballz's picture


reminds me of watching pro football.

Not really sure what you are all upset about.

Men in tights can't hug each other?

All Risk No Reward's picture

They admit to 106,000 killed annually and 2,000,000 hospitalized, temporarily maimed and/or permanently maimed.


You can figure that number is lowballed probably worse than unemployment.

In the meantime, the Biggest Finance Capital Medical Complex complains about synthetic vitamins and refuses to tell people about others reversing their multiple sclerosis and reducing theirt risk of diabetes through a nutritionally dense, anti-inflammatory diet:

Minding Your Mitochondria


An Interview with Michael Adams – “Curing MS with the Paleo Diet” – #181


83% Reduction in Diabetes Incidence in Highest Genetic Risk Group


The kicker, though, is that the dElites REJECT allopathic medicine that they created for their proletariat.

John D. Rockefeller used hoomeopathic medicine, as did the dElites of his day.

David de Rothschild is a naturopathic doctor who owns and runs an organic farm

They finance the message that the very medicine they use is "quackery" so that the allopaths become so biased to it that their closed minds will never investigate how they are much better approaches to health, even if they don't maximize Rockefeller Interest profits filtering brain shrinking, IQ reducing drugs through the sheeple.

It is a brilliantly executed plan because MDs tend to have minds more closed than the DMV at midnight - no matter how much evidence is presented.

How otherwise very intelligent people can be conned into thinking that anecdotal evidence is the end of the a matter instead of the beginning of a matter (imagine Newton dismissing gravity because the apple he saw falling was anecdotal evidence) is beyond my comprehension ability.  The process used to lobotomize the questioning portion of the typical allopathic doctor's mind must be powerful mojo.

duo's picture

The Mitochondria video is worth watching if you are new to the concept that processed foods are killing us.

I'm surprised she didn't mention dandelion leaves, which are more nutritious than kale WRT vitamin content.

drstrangelove73's picture


Sick people go to the hospital.
Sick people go to the hospital to die.

This just in:sick people die in the hospital everyday AS A PART OF THE NORMAL COURSE OF HUMAN LIFE..

My favorite ambulance chaser ad of all time was the solicitation to contact the law firm of Dewey,Cheatum,and Howe if "...a loved one died within 48 hours of receiving hemodialysis..."

Thought experiment:

If hemodialysis patients are among the sickest chronically ill people in the population.

And if each hemodialysis patient dialyzes every other day and sees a physician at each dialysis session;

What percentage of dialysis patients who die will have received hemodialysis within the previous 48 hours?

Chuck Walla's picture

Sears once offered funeral services. Probably next the Kenmore freezers.


Anusocracy's picture

Obamadontcare how screwed over the public is.

duo's picture

I expected something other than surrender of the the individual mandate from the administration. How about “If you’re uninsured because your plan was canceled, and you get sick after Jan 1, you can join the “Obamacare emergency exchange”, where we will give you health care for free in exchange for 9.5% of your salary” (up to $117K).

Suddenly, you have 8 million self-employed and business owners enrolled in single-payer, and it will only take a year to suck in the rest (business won’t wait to cost-shift health care onto their employees).

Come on, Obama/Jarret/Lucifer, use some imagination.

Abiotic Oil's picture

I work for a hospital system.

Since 2007 private insurance payers have been dropping, believed to be due to inability to pay high deductibles on necessary procedures, so they just aren't getting care.

Medicare/caid usage is rising, with hospitals being reimbursed .29 on the dollar, and that is scheduled to decrease. Aging poplation that has not taken care of itself and suffers from obesity and its complications, i.e. diabetes, blown out hips and knees, cancer, which are all "covered" by Medicare/caid.

Charity care is rising.

Huge layoffs where I work, again. First they gutted the worker bees and outsourced some dept's. Then when that wasn't enough, across the board paycuts and salary reductions. That still wasn't enough so middle management got a haircut and now they are finally forced to eliminate administration, always the last to go.

Docs suddenly deciding to retire.

Now private insurance co-pays and deductibles are going through the roof. My insurance, which is amazing, just went up 86% due to Obamacare. This will all equal less private insurance payers.

I can't remember the exact number but if a hospital falls below having 80 days cash on hand to run operations the Feds step in and take everything over, or the doors close.

So by plan or incompetence, we could be facing the Feds, who can't organize a two car parade of assclowns, will be running hospitals in this country.

Jena's picture

And anyone who is familiar with the VA system wouldn't want to be treated there.  But that is the trend.

Laughing Stock's picture

Exactly right!

One of the goals of healthcare reform should be a sustained decline in hospital visits.  So if fat fucking American slobs start taking better care of themselves all the better.

Also, one of the reasons deductibles under ACA are higher is because FatMericans think that the minute their fat slob kid gets the sniffles they need to rush the little douche to the ER.  It's about time these assholes had to think twice before wasting our healthcare resources.  As in, feel some out of pocket pain before heading to the doctor at the the drop of a hat every other day.

But the appologists will claim -- they paid for the insurance, so they should get to use it whenever they want -- BZZZZ -- wrong -- what they are doing is running up costs under the program, which results in higher premiums for everyone.  The old "I's gotz minez" 'hood mentality.

They run a commercial here in the NY tri-state area with some old geriatric c**t.  She yammers on about her heart doctor, her back dostor, her foot doctor...yada yad yada.  Some of these old assholes spend all day going to different docters and living off meds.  Fuck 'em.  Go for a walk you fat fucks!

'bout time!


Hal n back's picture

How embarrassing; Sarah Pailin was right.


Falling Down's picture

Or as Boris might say, "ObamaCare is work for you".

Hey Assholes's picture

Don't worry, the vaccines, GMO food, reccomendations to not take vitamins etc... will have people plenty sick in the near future.


Morticians, thats the future, morticians.

max2205's picture

That's what happens when you close ERs after 9 PM

logically possible's picture

And in other news..... Morgues have been doing record business.

duo's picture

The multivitamin hit-job of course didn't mention that fact that processed foods have almost no nutrition.  It also didn't mention that a  large part of current health problems come from a lack of minerals (Magnesium, Zinc) and vitamin D (sunlight).

Multivitamins aren't the best way to get vitamins (some are water soluable, some fat), and you run the risk of getting too much B6 while not getting enough D3.

Kamehameha's picture

you go in that hospital you can come out missing a kidney if not worse.  where did that organ donor card you did not sign come from.  why are you completely sedated and being transferred over to hospice?

SafelyGraze's picture


what a dark and depressing vision of life in hospitalstan


Miffed Microbiologist's picture

The hospital I work for was recently fined for removing the wrong kidney from a patient. This was reported in the news. It turns out the patient was admitted to another hospital and they had improperly marked the wrong kidney to be removed and he was transferred to us for the surgery. My hospital followed checking and rechecking documentation to verify the correct organ to be removed but it was to no avail. The other hospital called later to say it had been marked incorrectly but it was too late. I'm sure the other hospital received fines but we were too even though we weren't the cause of the error.

It's really is important to have someone advocating your care when you are incapacited. Pick the uber asshole of your friends or family who will watch your back aggressively. I've had friends ask me to accompany them to the ER just knowing I'd have their back in a critical situation and am not intimidated by white coats.


americanspirit's picture

Dear Miffed - a lot of people give a lot of advice on ZH - some of it is even worthwhile. But the advice you give here is the best of the best.

I'm not sure that the "uber asshole" is the one you want - it can be counterproductive to antagonize people unnecessarily.

But someone who is not only not intimidated but who makes it clear that they are not going away until the problem - whatever it is - gets resolved satisfactorily and who doesn't mind being thought of as an asshole if that is what it takes is definitely the one you want. I could tell stories .....

Miffed Microbiologist's picture

Dear Americanspirit, I am truly honored by your kind comment considering I'm a microbiologist and not educated in economics. That I could help anyone here gives me great joy and I am happy I can return the favor to all that have helped me see behind the curtain of our global economic ponzi scheme. Truly I am thankful to have found ZH and the motley Crüe who post here.

Perhaps I was a bit too strong to designate ones advocate as uber asshole. I have seen patients and their families get caught up in the medical field an never question what is going on with their care. They assume they will be taken care of. Even in the best of hospitals, the staff are stressed and overworked. Patient care is extremely complicated now. I've seen patients on 30+ meds with multiple drs on their cases. Recipe for disaster. People need to question and advocate for themselves or get a knowledgable strong person to do it for them if they are unable to do it themselves.

The worst part is seeing patients in love with drs because they have a great bedside manner. Sometimes they are incompetent idiots and we all rally to keep them from seriously hurting someone. Other drs can be nasty SOBs but are technically brilliant. It's just very hard for patients to judge competence and the medical field does a bang up job keeping it that way. I'm sure you have many stories. So do I. Some I wish I could forget.


logically possible's picture

Miff, just curious, what is the fine for a wrong kidney these days?

Reckonball's picture

If you want your diseased kidney,you can can keep your diseased kidney..period...

Miffed Microbiologist's picture

If I remember correctly, for us it was around 100k which isn't much but when you have done nothing wrong it's a bit excessive IMHO. Probably just a governmental show of force. I am not sure if my hospital will contest it. I do not know what the fine was for the other hospital.


PFO's picture

Yo Miffed,


A Polish friend was sledding with kids last winter in South Bend, Indiana and on the last run [naturally] hit the fence at the bottom of the hill fracturing 4-year old daughters leg.

He called 80+ year old Polish-American doctor upon arrival at the home-hearth who came over and splinted the break with a magazine! Then said "Go to Memorial Hospital tomorrow and have them take an X-Ray and I'll come set the break and cast it on the dining-room table the next day after the swelling goes down.

Dad made a big mistake by calling the US female across the street to ask her to accompany him to the hospital the next day to 'have his back' with the staff.

SHE said "If it was my kid, I'd take her to the ER right now!"

A perfectly programmed US feminist, whose mother is a . . . wait-for-it . . . NURSE!

So down to the ER they go at 8PM on a Sunday night. The staff tells Dad he must allow them to treat his daughter or she may be crippled for life and proceed to run him through the wringer.

$13,000 later the child's leg is cast and yet still has a slight misalignment in the set bone despite all the hoopla of the Memorial Hospital staff.

Dad finally tells me the tale several months later, concerned that he cannot pay the bill [+$9K]  left after the insurance vultures have vomited and is uncertain what impact this will have on his research at Notre Dame University and even his return to Poland. No worries I say and make an appointment to see the Memorial Hospital Risk Manager!

She [naturally] turns out to be a +$95K a year pig who can only spout the party-line which sounds like:

"That little girl received the finest medical care in the world." 

Amazingly, the Patient Accounts Representative offered a 30% credit without even being asked!!! WoW!

When I took from my briefcase and laid on the table - the cover-page of a letter from the FDA to Memorial complaining about their lackadaisical management of some R&D project, it was game-over.

I never referred to the letter, just left it on the table but kept asking who was in the ER to advocate for patients.

She actually replied she was trained as an advocate and when I asked how someone could contact her, gave me her extension. I replied that without literature or signs she simply did not exist to the hospitaling public and the look on her face was well-worth the whole ordeal.

My Polish friend even compared the bill to a Simpsons episode he'd seen in Poland years before where Homer goes to the 'hospital' and gets a $100K estimate to repair him. He then goes down the street to the 'walk-in clinic' and gets a $5,000 estimate and the advice that price doesn't matter, cause neither proceedure works and he'll be dead in 6 months either way. 

We both chuckled at this as the girls sat like funeral statues - two totally feminized droids, completely mentally crippled to the reality around them.

Never-the-less my Polish friend received a letter the next week 'zeroing the account' and asking him to forestall his daughter from 'filing any legal action when she turns 18.'

I went to say goodbye on the day the family returned to Poland and ran around the yard a few times with daughter, now outta cast, but with a slight 'kink' below the right knee. She jumped vivaciously off the porch squealing with delight.

The +80 year old Polish Doctor arrived to drive them to O'Hara and when he found out who I was he couldn't contain his amazement at what had been accomplished. He had NEVER heard of anyone standing up to the hospital over a bill and winning!

Moral of the story:

Whenever ANYONE bills you unfairly - FIND THE RISK MANAGER!!

It matters not what organization [church-government-private-public] you are dealing with.


Call the administrative or government agency that regulates the billing party and FIND the individual who personally handles their account. Ask for a complaint form and the agency's procedures manual and administrative or state codes for handling complaints.





All Risk No Reward's picture

I went in to have surgery to repair a broken finger and the doctor came in and started rubbing the wrong finger...  He seemed a bit surprised when I point out he wasn't rubbing my broken finger...  it worked out in the end, but he was eyeing the wrong finger initially.

He may well have trained himself to do that as a doublecheck - I don't know.  If it was luck, though, I hope he learned a lesson and verifies what he's doing before he actually does it.

Othewrwise, no complaints.

ebworthen's picture

I deny every check box and offer to donate organs.

Too much gin and tobacco, but if i go in and I'm borderline and they find out I'm donating organs I'm SURE they will pull the plug and sell my organs.

Common sense.

ceilidh_trail's picture

When will this nation finally realize that this guy is a complete incompetent?   Or is he...?

NoDebt's picture

All those who have been roused from their stupor are all that will ever be roused from it.  Only generational changes in opinions will move the needle from here.

As I learned just recently, things may not be as dim as we currently think.  I understand that the under-25 crowd is going STRONGLY conservative a la Ron Paul (limited government, Constitutional principles, etc.)  It was, perhaps, the best Christmas present I've had in a while.

That is the ONLY thing that has given me real hope this year (not the false hope offered by the fraud and liar in the White House).  And I do mean the ONLY thing.  All else is already a rather dim shade of charcoal and growing darker by the day.

MedicalQuack's picture

Yes and let's look at CMS bragging that their re-admission penalty program is working, well if admissions are down then would it not go to follow that re-admissions are down too:)  It's not their QE based program executing coding fines on hospitals is it?

Hospitals are doing better though with working with patients with "human" interactions and not math models to accomplish this though.  Heck you don't know if you are "admitted" or "admitted for observation" if you are on Medicare as the doctors have to work the coding.  Heck my ex was an MD and he used to have to sit through hospital admin meetings to where they told him he was not meeting his admission quota and don't think that doesn't make a doctor shooting mad. Here's a great video from the Texas Medical Association..tells all.


They just keep shifting the money around...and big name hospitals get fined too:)




dryam's picture

Admission quotas are unlawful.  If I was your husband I would have took a stand, gotten fired, filed a no-brainer whistleblower lawsuit, and then retired.

Two or three years ago a similar thing happened with a very large hospital system in California with their ED's & quotas.  A couple of doctors were fired & they brought the lawsuit forward & won.  The hospitals were heavily fined & the whistleblowers were well compensated.

MedicalQuack's picture

I am in California and yes that got attention and hopefully was fixed, well until it comes up again somewhere.

ebworthen's picture

As time progresses, whistelblowers like that will be treated like Edward Snowden.