Observation status has become a wild card factor in the daily hand dealt to patients, payers and providers. The status has become a catchall status that is often applied based on arbitrary or vague criteria. As hospitals try to react operationally and contractually, payers continue to expand the concept, diluting clinical criteria while expanding time frames for treatment and utilization review, that is at best confusing to clinicians, administrators and patients. Health systems and their medical staffs need to define the status for themselves and practice accordingly. Observation Points Observation status as an entity has risen dramatically in the past 5 years.
Observation costs hospitals millions of dollars in revenue.
Observation status changes cause problems for hospital information systems. These changes cause billing delays and consternation in UR committees. If symptoms persisted or worsened, care could be initiated immediately. If the patient improved or the etiology proved to be benign, the patient would be discharged and for the reduced cost of observation, the patient would receive the monitoring and care that was appropriate. The prototype situation was the presentation of a patient with chest pain.