http://pubs.aeaweb.org/doi/pdfplus/10.1257/jep.28.1.209
Monday, 21 April 2014
Saturday, 25 January 2014
US hospitals admit unnecessarily
http://www.fbi.gov/about-us/investigate/white_collar/health-care-fraud
Sarah O'Leary
Los Angeles, CA Yesterday
http://www.nytimes.com/2014/01/24/business/hospital-chain-said-to-scheme-to-inflate-bills.html?partner=rss&emc=rss&smid=tw-nytimes
Yesterday
Happy Medium
New York, NY Yesterday
As a physician myself, I am not surprised at this. Doctors are human just like everybody else, and when pressure comes from above to swing one way or another, especially the subtle kinds of pressure that rankings and rewards represent, it's very easy to convince yourself that you're still doing the right thing in changing your practice behavior. Nobody is immune to social pressures or subtle pavlovian conditioning.
Ultimately the problem here is not truly the frontline MDs, though I bet that they're the first who will get penalized. It's the corporatization of medicine, the demand for higher and higher profit. I'm not talking about just for-profit hospitals, non-for-profit hospital systems often take just as much out of the system, only in those cases money is being extracted out in salary for those in the C-suite. Executives are often so divorced from the practice of medical care, that they don't see or care about the "helping and healing" aspect of care. Sometimes the pressure they exert is generally for the better, for example in the push for shorter hospital stays, but often for the worse as they drive the practice of bad medicine under the guise of efficiency.
Oh, and to those who say that all doctors are the problem. Be aware that is similar to saying "all teachers are terrible" there is an incredibly wide variety of MDs. Procedure oriented specialists make tons of money, but primary care doc salaries can be very mediocre.
Ultimately the problem here is not truly the frontline MDs, though I bet that they're the first who will get penalized. It's the corporatization of medicine, the demand for higher and higher profit. I'm not talking about just for-profit hospitals, non-for-profit hospital systems often take just as much out of the system, only in those cases money is being extracted out in salary for those in the C-suite. Executives are often so divorced from the practice of medical care, that they don't see or care about the "helping and healing" aspect of care. Sometimes the pressure they exert is generally for the better, for example in the push for shorter hospital stays, but often for the worse as they drive the practice of bad medicine under the guise of efficiency.
Oh, and to those who say that all doctors are the problem. Be aware that is similar to saying "all teachers are terrible" there is an incredibly wide variety of MDs. Procedure oriented specialists make tons of money, but primary care doc salaries can be very mediocre.
RB
Midwest Yesterday
I am a physician in a large group and we are also under a scorecard system each month regarding charges, tests ordered.I hate it! I am pretty sure it goes on more than you think. It is because the current system pays us to do more not to do what is right and necessary.
Frank Baudino
Aptos, CA Yesterday
As a primary care physician, I can tell you that this type of corruption is endemic in our medical care system. Emergency room physician groups coach their physicians on how to dictate (read "exaggerate") notes that will justify maximum reimbursement. I saw this in Merced, CA. I'm seeing the same type of thing in Santa Cruz, CA where the local hospital sponsors meaningless "screening tests" to pump up its bottom line.
It's time for single-payor.
It's time for single-payor.
Temperence Hill
Long Island, NY Yesterday
I keep forgetting, so please remind me:
Why is it that stealing billions from the government seldom results in a criminal prosecution, but shoplifting $50 leads to arrest and a felony charge?
Why is it that stealing billions from the government seldom results in a criminal prosecution, but shoplifting $50 leads to arrest and a felony charge?
Christina Hauck
Kansas Yesterday
"Still, when H.M.A. announced the Justice Department’s involvement in the lawsuits, investors and analysts shrugged, and the stocks for both companies involved in the merger barely budged." And here is the problem: the Federal Government coddles corporate interests. Until the government is willing to break the back of corporations that flaunt the law and charge and imprison the executives who drive the illegal activity, nothing will change. Oh, and it might help if the revolving doors between corporations and the federal government were closed, too.
Jack
Yesterday
Sadly this is very common. In fact, numerous not for profit institutions also practice the same way, just a lot more subtly. My friend who works as an admissions persons at a mid level acute rehab facility (under a not for profit institution) is under daily pressure to bring in more admissions. To buttress their philanthropic claims, they occasionally will admit a 'charity' case, but the doctors who admit and work with these patients, get penalized (by getting lower bonuses or no bonuses), as they bring in less 'collections'. The people who run the show in most hospitals are increasingly non healthcare providers. In my ICU, our Operations director is a 32 year old ex technician (who also know the CEO), who is clueless to the workings of an busy ICU.
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As the owner of a consumer healthcare advocacy, this article is sadly not surprising. We see cases like this on a daily basis.