Who else would award poor execution, incompetent quality control and substandard practices in medical care with more money than your friend and ours, the governement?
In Medicare’s upside-down reimbursement system, hospitals and doctors who order unnecessary tests, provide poor care or even injure patients often receive higher payments than those who provide efficient, high-quality medicine.
“It’s the exact opposite of what you would expect,” said Mary Brainerd, chief executive officer of HealthPartners, a nonprofit health plan based in Bloomington, Minn. Her Medicare HMO ranked among the top 10 in the nation last year for quality but was paid thousands of dollars less per patient by Medicare than lower-performing plans.
“The way Medicare is set up,” Brainerd said, “it actually punishes you for being good.”
This comes via the first part of a Washington Post series. And it is an eye-opener:
For a year, The Washington Post crisscrossed the country to examine the economics of Medicare and how it monitors the quality of its services — reviewing thousands of documents and interviewing hundreds of researchers, regulators and patients. Medicare is highly valued by 42 million elderly and disabled members, but it wastes an enormous amount of money on inefficient medicine, the examination found.
The scariest finding:
Medicare has outsourced many enforcement activities to private groups that have overlooked or missed cases in which patients were injured or killed, according to hundreds of inspection reports and interviews with state regulators. Some facilities haven’t been checked in years.
So? Why shouldn’t they be financially rewarded?
Joe Gandelman is a former fulltime journalist who freelanced in India, Spain, Bangladesh and Cypress writing for publications such as the Christian Science Monitor and Newsweek. He also did radio reports from Madrid for NPR’s All Things Considered. He has worked on two U.S. newspapers and quit the news biz in 1990 to go into entertainment. He also has written for The Week and several online publications, did a column for Cagle Cartoons Syndicate and has appeared on CNN.