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The Challenge of Hospital Observation Status: A Discussion With Andria Jacobs
Patients who get care at a hospital often receive bills that are bigger than they were expecting. In the case of Medicare, this can happen when a beneficiary receives care at a hospital for several days but was never formally admitted to the hospital.
Patients who get care at a hospital often receive bills that are bigger than they were expecting. In the case of Medicare, this can happen when a beneficiary receives care at a hospital for several days but was never formally admitted to the hospital. The result is higher out-of-pocket expenses and fewer Medicare benefits—the biggest being the qualification of a nursing home stay after being discharged from a hospital. While hospitals must now inform Medicare recipients when they are being held under observation status, the use of observation still places an undue burden on seniors.
Andria Jacobs, chief operating officer for PCG Software, discusses the impact of being held in observation, what CMS has done to try to alleviate the situation, and what else needs to be done.
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Price Transparency With Gaps: Assessing the Completeness of Payer Transparency in Coverage Data
December 9th 2025In analyzing 2025 Transparency in Coverage (TIC) files from national insurers, the authors found vast payer-level differences; overall, physician/outpatient data were more complete, and hospital inpatient data were less complete.
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