Expanding weekend and holiday clinical services: a financial perspective.

Many payers view weekend and holiday inpatient stays at hospitals that provide interventional and therapeutic services only on weekdays as unnecessary, and are denying payment for these days. Hospitals not only must absorb the incremental costs associated with maintaining patients during these days, but also may lose payment for days to which they legitimately are entitled. To reduce both costs and denied payments, hospitals should develop a means to identify unnecessary days; provide immediate feedback to physicians in a manner that helps reduce problematic days; and place a priority, when appropriate, on moving patients to lower-level care settings, such as skilled nursing, home health, and custodial care facilities.