3M’s Medicare Boondoggle
WASHINGTON, July 16 — The Bush administration says it plans sweeping changes in Medicare payments to hospitals that could cut payments by 20 percent to 30 percent for many complex treatments and new technologies.[...]
Medicare pays more than $125 billion a year to nearly 5,000 hospitals. The new plan is not expected to save money, but will shift around billions of dollars, creating clear winners and losers. The effects will ripple through the health care system because many private insurers and state Medicaid programs follow Medicare’s example.
Okay, so there’s a good reason for this, right? We did thorough research and are making the necessary adjustments because of it, yes? Well, sort of…but here’s where it gets really strange/interesting/sad.
Because yet again, we find a variety of the “no-bid” contract we’ve become accustomed to from this administration. However, this time we paid a company (3M) to look at our current Medicare system and see if their own billing technology could help make the system run smoother.
Yes, you read that right. We paid a company to investigate their own software’s usefulness for the billions of Medicare payments that are processed each year. Anybody want to guess what they found?
This is laughable. Check out this logic from 3M:
Richard F. Averill, research director of 3M Health Information Systems, said the sole-source contract was justified and denied that his company had a conflict of interest. As an inventor of the 1983 payment system, Mr. Averill said, he and his colleagues at 3M know more about it than their competitors.Moreover, Mr. Averill said in an interview: “The contract required us to use the 3M system in our analysis. There was no evaluation of alternatives.�
My friends, these are truly “amazing” times.
Oh yes, and one last thing…this move has the potential to drive up healthcare costs.
When hospitals lose Medicare revenue, they often seek higher reimbursement from private insurers. J. Brian Munroe, vice president of WellPoint, one of the largest private plans, said he feared that the Medicare changes “will introduce a significant amount of disruption to the commercial health insurance marketplace, driving up health care costs and causing marketplace confusion.�
Good times.
opinions powered by SendLove.to
6 Responses to “3M’s Medicare Boondoggle”
This got to be some sort of joke
I don’t think the article gives enough unbiased information to make a judgement. Note for the below that I am neither an accountant nor a doctor.
This seems to be a needed change : the current medicare system pays based on only the name of the disease, not the individual treatments or even severity of disease (from personal experience, on Crohn’s Disease patient can be treated entirely with a cheap generic drug and have years of remission, while a second can require regular expensive name-brand infusion treatments to avoid a hospital stay, and yet a third may simply require invasive care to treat). This seems like a good way to have massive oversights and wasted money on individuals with minor conditions, or, worse, individuals with severe illnesses that aren’t affordable to treat.
I can’t find much information on the new version of the system; so far, only the NYTimes has reported on it (hm…) with a couple minor postings elsewhere. It seems like the goal
This will, obviously, hurt doctors who can no longer milk patients with minor conditions. I’m not sure exactly how valid or dangerous it is, though, or if we should really encourage doctors to take excess government funding to drive down prices for other folks (since the excess funding comes from other folk’s paychecks anyway).
As to why 3M measured its own system : it appeared to be the only one that could for legal and technical reasons. I think the company as a whole can be sued by the government for the cost of the system and more if the analysis is shown to be flawed, so it’s not as ugly as you’d expect.
This doesn’t even remotely pass the smell test.
DC productions brings you…Corrupt CEO Culture run amok in DC! (CCCraDC…(kinda like a twisted CCR)
The very same culture that brought these big hits!
Enron!
HealthSouth!
Halliburton!
Bechtel!
And now 3M!
So many hits in this overpriced compilation, you’ll be broke on the streets grooving to them all summer!
Only $9999999999999999999999999999999999999999999.99
Get it now suckers!
gattsuru, I’m not a doctor, a lawyer or an accountant. I am, however, an IT jack of all trades for my company who reads about IT systems for larger companies and general theory and concepts in the area. This stinks. Really. There are third party companies who do nothing but evaluate software systems whatever field they might be applied to. For a no bid contract to be let to 3M to evaluate its own software when so much money is on the line for 3M is a joke. You just can’t consider this an effective evaluation.
We spend more for health than any other country on earth, and yet our health care system is like 17th or something.
It’s long past time for single payer. All the idiots who start in with the obligatory “we cant do that, its socialism” can kiss my hineee.
We tried suppossed free market and it sucks. Like cronyism and rip-offs could ever be free markets.
Time for some adults to start running things.