Payors Downgrading More Inpatient Claims to Observation Status

In southeastern Pennsylvania, payors' downgrades of hospitals' inpatient claims to observation status increased by more than 45 percent from Jan. to Aug. 2010, according to a report by the Philadelphia Business Journal.

A survey of 29 hospitals by the Delaware Valley Healthcare Council found that while admissions decreased slightly, from 38,405 to 36,222, the number of patients identified as observation cases rose from 4,690 to 6,820.

In a previous survey of council members in 2008-2009, downgrades rose by nearly 30 percent, from 3,767 downgrades in 2008 to 4,768 in 2009.

Observation status is a billing category for patients not sick enough to be admitted to the hospital but not ready to be sent home.

Read the Philadelphia Business Journal report on hospital payments.

Read more coverage on use of observation status in hospitals:

- Observation Status Used More Often by Hospitals

- Getting Ahead of the Curve – 12 Weeks to Evidence-Based Best Practices

- 10 Key Concepts on Building an ACO: From Linde Wilson of Aria Health


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