Tag: "Medicare"

Can Medicare Root Out Fraud? Not If the Past is Any Guide.

When the Medicare Part D drug benefit was established in 2006, the legislation contained provisions designed to combat fraud within the program. However, according to a new report from the Office of Inspector General, the government was slow to provide the necessary tools for the sleuths (Medicare antifraud contractors) to adequately do their job.

To discover fraud, the contractors need to analyze beneficiary data for unusual patterns of drug utilization. In several instances, it took the government two to three years to provide contractors with this data — much of which turned out to be riddled with errors. Of the cases of suspected fraud, four in five were the result of tips or complaints rather than data analysis.

Nov 12, 2009 | 4 comments | by

Obama Wants to Spend Less Money on You at the End of Your Life

This is from The New York Times:

At New York University Langone Medical Center, for example, Medicare spending was $105,000 per patient during the last two years of life. During the last six months of life, when costs go up still more sharply, patients at the center spent an average of 31 days in the hospital and were visited by 77 doctors.

At Genesis Medical Center in Davenport, Iowa…Medicare spending was $40,000 per patient during the last two years, and during the last six months, patients spent 14 days in the hospital and were visited by 29 doctors.

Nov 12, 2009 | 9 comments | by

Saving for Health Care in Retirement

Medicare covers only about 60% of the cost of health care during retirement. Seniors often underestimate the amount that they are responsible for. According to the Employee Benefit Research Institute, men need to have saved $68,000 to $178,000; while women need anywhere from $98,000 to $242,000 in retirement savings dedicated to health care.  Even with these large amounts, men and women still have only a 50% chance of having sufficient funds for medical care during retirement.

Saving-for-HC-in-Retirement-smaller

Nov 12, 2009 | 6 comments | by

Cost of the Medicare Physician Payment Fix (SRG): Four Trillion Dollars

 

Impact-of-HR-3961-on-the-Long-Term-Medicare-Unfunded-Liability

Nov 12, 2009 | 4 comments | by

Squeezing the Providers, Part I

The political left in the United States, and for that matter, throughout the world, only knows two ways to try to control health care costs: (1) squeeze the providers and (2) deny patients care. Since they don’t believe in markets or economic incentives or entrepreneurship (the way costs are controlled in other markets), all that’s left is to take it out on doctors and patients.

Today I will address the doctors. To help our thinking, consider these four questions:

  1. Since Medicare pays doctors less than private plans, can we lower the cost of care by enrolling everyone in Medicare?
  2. If through force of law or power of negotiations, we managed to suppress all provider fees, would that lower the cost of care?
  3. Since nonprofit entities don’t have to earn a profit, could we lower the cost of care by outlawing the profit motive in health care?
  4. Have other countries lowered their cost of health care by paying providers less than what we pay?

The answer to all these questions is basically “no.” If you are inclined to answer “yes,” you don’t understand the concept of social cost. But don’t feel too bad. That would put you in the company of some very smart people — who I will charitably decline to name.

Read More » »

Nov 11, 2009 | 29 comments | by

Tell Me Again About the Definition of Insanity…

This is from Kaiser Health News:

Medicare has conducted hundreds of tests, called pilots or demonstration projects, since the mid-1970s… Most of these experiments haven’t been expanded because they failed a threshold test; they didn’t save money or improve care. Others passed the test but were derailed by objections from hospitals, doctors and other providers — or were caught up in political fights as control of Congress shifted.

So what do the reform bills in Congress promise? Much more of the same.

Nov 11, 2009 | 5 comments | by

Report Card on Quality

This is from a report by the National Committee for Quality Assurance (NCQA):

The Good:

  • A 12 percentage point jump in the provision of beta-blocker drugs to Medicare patients who had a heart attack within the previous 6 months.
  • Near universal high-quality care for Americans with asthma.
  • Substantial gains in helping Medicaid beneficiaries stop smoking.

Read More » »

Nov 10, 2009 | 5 comments | by

Worst Editorial of the Year Award

This is Robert Frank, writing in The New York Times:

If the Mayo model is better and cheaper, why hasn’t it swept the market like wildfire?

He gives six separate answers (that’s right: six!) and all of them are wrong!

The answer, supplied by yours truly in A Framework for Medicare Reform is that (1) Medicare punishes Mayo for supplying low-cost, high-quality care and rewards other hospitals for doing the opposite and (2) private payers have been pushed to pay the same way Medicare pays.

Nov 09, 2009 | 7 comments | by

To Their Own Devices

Five years later, Medicare underwrites more than half of the $4 billion the nation now spends annually on defibrillators, but the agency is no closer to knowing how many lives that big investment is saving. That is because the device companies did not finance the study beyond their initial $4 million commitment, and Medicare did not pick up the slack. As a result, researchers still cannot gather data that would identify the types of patients who would most benefit from a defibrillator.

Full article in The New York Times.

Nov 06, 2009 | 3 comments | by

Lewin on Baucus

If you like the plan you have, you may not be able to keep it:

  • 19.1 million will lose their employer coverage
  • 11.8 million others will gain employer coverage
  • 14.1 million will newly enroll in Medicaid
  • 17.1 million will be insured through a managed-competition style exchange
Nov 03, 2009 | 5 comments | by
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