Hospital COVID payments tied to patient treatment, not deaths – The Associated Press – en Español

CLAIM: U.S. hospitals are earning a $48,000 government subsidy for every patient that dies from COVID-19 in their care.

AP’S ASSESSMENT: False. Hospital industry officials and public health experts confirm the federal government provides hospitals with enhanced payments for treating COVID-19 patients, but the payments are only currently applicable to those on Medicare. The enhanced payments, which are slated to end in May, also aren’t contingent on a patient’s death but on the treatment or services provided to the patient, they said.

THE FACTS: Social media users are claiming American hospitals have a financial incentive to let people with coronavirus die under their watch.

Many posts are sharing a screengrab of a post featuring an image of a group of health professionals posing together while fully covered in personal protective equipment.

“Wait until everyone finds out that hospitals nationwide murdered people simply to collect COVID subsidies at $48,000 per death,” the screenshot reads in part.

“That should give people a bit of clarification on how our medical system works if they didn’t know already,” wrote one Instagram user in a lengthy post that included the screengrab.

But hospitals have never been compensated by the federal government based on a patient dying of COVID-19 in one of their facilities, say industry officials and public health experts.

During the pandemic, hospitals have received additional money for treating COVID-19 patients as part of the Coronavirus Aid, Relief, and Economic Security Act, or CARES, the 2020 law meant to address the economic fallout of the pandemic.

But those increased payments don’t apply to every COVID-19 patient treated in a hospital, just the ones under Medicare, which is the federal healthcare program serving people 65 and over.

Colin Milligan, a spokesperson for the American Hospital Association, confirmed that hospitals are currently eligible to receive a 20% increase in Medicare payments for caring for COVID-19 patients.

“These patients are often very costly and time and labor-intensive for hospitals to treat,” he explained in an email Wednesday. “In addition, it is important to highlight that Medicare and Medicaid both reimburse hospitals far less than the cost of actually providing care.”

Milligan also pointed to a statement the hospital trade group released in 2020 when concerns about the industry’s profits during the pandemic became a focus of debate.

“Hospitals do not receive extra funds when patients die from COVID-19,” Rick Pollack, the association’s president, said in the statement. “They are not over-reporting COVID-19 cases. And, they are not making money on treating COVID-19.”

And despite what the social media posts claim, the enhanced COVID-19 payments aren’t based on whether the patient lives or dies, experts said.

“This is a stupid lie that apparently, like a zombie, refuses to die,” Gerald Kominski, a senior fellow and former director at the UCLA Center for Health Policy Research, wrote in an email. “The most common lie about this fact is that every COVID hospitalization (i.e., including on-Medicare) meant more payment (FALSE) and hospitals only got paid more if the patient died (FALSE).”

In general, Medicare payments are based on the severity of the patient’s condition and the types of treatments provided, said Juliette Cubanski, deputy director of Medicare policy at the Kaiser Family Foundation, a San Francisco nonprofit focused on health policy issues. A sicker patient will require more medical services, meaning their Medicare bill will be larger.

The average cost of a COVID-19 hospitalization for a Medicare patient is about $24,000, she said, citing claims data from Centers for Medicare & Medicaid Services, the federal agency that oversees the government healthcare programs. But the reimbursement for more severely ill patients — such as those placed on a ventilator for multiple days — is roughly $40,000, according to KFF’s analysis.

Social media posts citing a $48,000 subsidy for COVID-19 deaths appear to be taking that $40,000 average cost for treating the sickest COVID-19 patients and factoring in the special 20% reimbursement rate increase. But Cubanski argued that’s not a fair assessment of the potential payout to hospitals.

“My understanding of the estimates from CMS is that they already include the 20% payment increase in the stated amount,” she wrote in an email. “So the payment for an extreme case would be $40k including the 20% increase, not $40k plus 20%.”

Spokespersons for CMS and the U.S. Department of Health and Human Services, which oversees the agency, didn’t respond to emails seeking comment this week.

But President Joe Biden has announced the federal government’s declaration of a public health emergency for COVID-19 will end on May 11.

That means the enhanced Medicare payments — along with other measures the federal government enacted to weather the pandemic — will soon be a thing of the past.

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This is part of AP’s effort to address widely shared misinformation, including work with outside companies and organizations to add factual context to misleading content that is circulating online. Learn more about fact-checking at AP.