Medicare Urged to Look Harder at Value of Services Provided 

Our perception of quality health care tends to follow the more is better philosophy. There are many studies that refute that, but convincing people and even doctors is not easy.

If Medicare was run efficiently, these issues would not occur not only for better health care, but for managing costs. However, to improve the situation you can bet “rationing” will become the battle cry

WASHINGTON — Medicare should work harder on ferreting out the services it shouldn’t be paying for because they either don’t help patients or actually do them harm, several members of the Medicare Payment Advisory Commission (MedPAC) said. “This is really important work because it’s win/win,” said commission member Rita Redberg, MD, of the University of California San Francisco. “Besides the billions that people are spending, people are being hurt. There is nothing good about getting tests you don’t need and aren’t going to help you feel better.”

In 2014, Medicare spent anywhere from $2.4 billion to $6.5 billion on these types of services, which are known as “low-value care,” MedPAC staff member Ariel Winter said during a commission meeting on Thursday. To arrive at those numbers, commission members analyzed Medicare claims data from 2012 to 2014, using 31 measures of low-value care developed by Aaron Schwartz of Harvard University and colleagues. The range in the estimate is because they looked at both a broad and a narrow version of each measure.

Approximately 37% of beneficiaries received at least one low-value service in 2014 if the broader measures were included, Winter said. In terms of volume, most of those services fell under two categories — imaging and cancer screening — while most of the spending on low-value services came in the areas of cardiovascular tests and procedures, and other surgical procedures, he said.

Source: Medicare Urged to Look Harder at Value of Services Provided | Medpage Today


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