Saturday, September 8, 2012
Hi everyone - glad to see many of you were able to get/accept the invite to be blog authors. Been a busy week with the DNC and the platform back and forth. This IOM report about waste also caught my eye as something we hear about all the time. Thoughts?
http://www.kaiserhealthnews.org/Daily-Reports/2012/September/07/iom-report.aspx
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Thirty percent of U.S. medical expenses wasted – that’s a pretty staggering number, although I’d be curious to know more about the methodologies used to reach this figure and what was classified as “waste.” Clearly, there is opportunity to save money without rationing or sacrificing needed care. I found it interesting that the report focused in large part on doctor education as a solution, an idea I don’t often hear discussed. I think doctor education would be a good way to reduce wasteful spending by doctors who are unknowingly recommending inappropriate care, and better informed doctors may also reduce the number of medical errors that tragically lead to deaths (estimated at up to 98,000 per year according to the Medscape summary). Financial incentives such as P4P and reimbursement reforms may help, but they can only go so far if the physician doesn’t have the information to know when their services are wasteful and when they aren’t. However, it also seems possible that teaching physicians about new technologies and treatment options could increase health care costs if they are learning about new, more expensive treatments that are available.
This reminds that a couple of years ago the medical director of our Queens hospice team took an extended "vacation." When he was silently replaced and no mention of his whereabouts or possible return were mentioned someone in the office googled his name and discovered that he had been indicted in Michigan, where he lived previously, for an elaborate $50M Medicare fraud scheme. Evidently, he and some cronies set up these pharmacies for the sole purpose of receiving Medicare reimbursement for made-up prescriptions for made-up people. He was one of two doctors charged with writing these prescriptions. I haven't heard what happened with the case since, but he has not been seen or heard from.
I almost forgot, a year later, the head of IT was fired and arrested (in that order, I think) for skimming $300,000 worth of computers from the agency. It was an administrative embarrassment that it took over a year to discover the auditing discrepancy.
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