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View Diary: Abbreviated Pundit Round-up: More on the benefits of Obamacare (55 comments)

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  •  Public disclosure of physician ratings (2+ / 0-)

    does seem badly misguided . .. . .

    CMS hopes the data will “help consumers compare the services provided and payments received by individual health care providers. Businesses and consumers alike can use these data to drive decision-making and reward quality, cost-effective care.” The word choice here—“consumers,” not “patients”—is a cue that CMS wants to enlist market forces to discipline errant physicians. Call it consumer-directed health care, Medicare-style.
    Ultimately it would seem to make care for high risk and difficult to treat conditions all that much more difficult, and low quality as physicians shy away from such areas in fear of the rankings . ..
    •  More useful to gauge fraud (12+ / 0-)

      There are jokes about lawyers who manage to bill 36 hours in a single day, day after day. It would be interesting, to say the least, for the Feds to drill down into the data and find out if there are doctors regularly billing far more than a person could possibly really do in a day.

      Example: A relative of mine spent several years in a nursing home. When I took over her finances, I kept finding Medicare payments to a podiatrist -- including for dates when she was hospitalized. I strongly suspect that he went in, saw a couple of people, cut a few toenails, and billed Medicare for specialized services (which is what Medicare will pay for) for every single patient, month after month.

      The fact that the geographic spread is very uneven lends credence to the fraud theory. The number of radiology or chemo services per population shouldn't vary that much between, say, Florida and Arizona.  

      •  nice balanced piece here as to where to go (8+ / 0-)

        from here:

        The promise and peril of new Medicare data
        Newly-released Medicare payment data offer key clues to how physicians practice, get paid—if reporters proceed carefully
        http://www.cjr.org/...

        "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

        by Greg Dworkin on Thu Apr 10, 2014 at 05:25:14 AM PDT

        [ Parent ]

      •  It also exposes legal but sleazy practices that (3+ / 0-)

        Congress has prevented Medicare from stopping. Friends of Senator Menendez having been doing really well under this system and apparently it is legal. Yesterday's NYT had a story about how the two Docs with the highest Medicare reimbursements in the country slushed hundreds of thousands to Menendez through Harry Reid's PAC. Not pleasant reading for those of us who hope Dems are better than that...reality bites.

      •  Sure, going after fraud is totally laudable (1+ / 0-)
        Recommended by:
        Heart of the Rockies

        but I hardly think that this needs to be the approach.

      •  Oh, yes (2+ / 0-)
        Recommended by:
        wintergreen8694, SoCalSal

        When my dad fell and broke his hip, then moved into a rehab after the replacement, there were doctors who would make regular visits to this rehab, find their patients on the list and go visit them, then (I'm sure) bill Medicaid for stopping in the room for 2 minutes.
        My father had a rare form of leukemia that had been in remission for over 10 years, and his oncologist showed up and wanted to do all kinds of tests to check on the leukemia. My mom threw him out, I'm proud to say.

        Your beliefs don't make you a better person. Your behavior does.

        by skohayes on Thu Apr 10, 2014 at 06:35:55 AM PDT

        [ Parent ]

        •  When did doctors become the Enemy? (0+ / 0-)

          btw the "2 minutes" in the room is the tip of the iceberg. You don't know about the time spent on phone calls looking for lab results, checking x-rays, consulting with other physicians, physical therapy, chart review. PAPERWORK. All in the service of your father.  Oh, and, btw he survived leukemia long enough to break his hip. Did he treat himself?

          You're welcome.

          •  It's Florida (1+ / 0-)
            Recommended by:
            sfbob

            My father went in that rehab and a week later was back in the hospital with aspiration pneumonia, stayed for 2 weeks (because of an untreated bedsore that got infected) and then back to another rehab.  Two weeks there and back to the hospital where they were talking about amputating his leg because he hadn't gotten the correct wound treatment at the second rehab. Unfortunately, the pneumonia killed him before they could decide on whether an 86 year old man in poor health could withstand an amputation surgery.
            I could tell you about my 50 year old girlfriend who went to a local hospital to have a hysterectomy, whoever closed her incision sewed her catheter in and they had to go back in and get that out, and then she developed a MRSA infection and instead of being in the hospital for 3 days, it turned out to be three weeks. The hospital's lawyer made sure to visit her on her release date to inform her that state law prevented her from recovering any damages from the hospital. I thought that was a nice touch.
            By the way, I work for a 3 vet practice, I understand about checking lab results, consultations, physical therapy, etc. I also know that the staff does most of the leg work.

            Your beliefs don't make you a better person. Your behavior does.

            by skohayes on Thu Apr 10, 2014 at 09:14:35 AM PDT

            [ Parent ]

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