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Will Medicare Changes Result in Better Quality?

September 3, 2012 in health care costs, Health Insurance, Hospital Bills, Insurance Bills, Medical Care, Medical Debt, Medicare

As the price of health care in America keeps rising, you may be among those that are frustrated by the kind of generic approach taken by  health insurance companies and government entitlement programs. The traditional fee-for-service format of health care reimbursement means that the best hospitals and doctor’s offices don’t get rewarded and the lower performing offices don’t have consequences. But, this is all likely to change with new Medicare rules that are slated to pursue more of a ‘meritocracy’ in the way that health care dollars get paid out.

New Medicare Rules

Reports from the Centers for Medicare and Medicaid Services show that Medicare is going to begin making some changes in the way that it reimburses health care providers starting late this year. In what Medicare officials call a ‘value-based purchasing’ program, Medicare will consider various aspects of a provider’s operations in setting the reimbursement rates for that particular office. Key factors will include observation of outcomes, or in other words, whether the procedures and services performed at an office actually help patients to recover from illnesses and improve quality of life.

Responses to the Changes

For you, this represents a major change and a big potential edge in making sure you get what you deserve for the money, especially when you have out of pocket expenses. On the downside, though, some providers are arguing that hospitals and offices in rural areas, or those with other significant disadvantages, may be punished unfairly. Read the rest of this entry →

Shopping For A Doctor Vs. A Dishwasher

December 14, 2011 in News

This is a perfect illustration of Healthcare Savvy’s reason for being: The Washington Post’s great WonkBlog writes here about how much effort people devote to shopping for a doctor vs. an appliance. You guessed it, the appliances win, hands down. But of course, it’s not for lack of interest or desire on the part of the health care consumers — it’s because we just don’t have as much data on doctors as dishwashers, for all sorts of reasons…Sarah Kliff writes:

This is surprising in the context of what a big chunk of consumer budgets go toward health care: The average family with employer-sponsored insurance spends $10,944 on premiums each year. But it’s perhaps explained by one of the survey’s other findings. Americans might not shop for health care because they have little confidence in their ability to do so. Shopping for a doctor is a lot harder than shopping for a dishwasher. There’s no price tag for what you’ll pay, or a Consumer Report to reference on quality. That might be one reason that Americans spend relatively little time thinking about their health-care spending choices: They don’t believe they’ll make a better choice for the cost or quality of care they receive.

Excellent comments follow, including:

“Doctors complain that a patient’s unique circumstances make it impossible to judge the patient outcome based on something the doctor did (or didn’t) do. I haven’t yet heard of an effort by physicians to help implement a ratings system that would be fair to both the patients and the doctors. There are a lot of stories about doctors fighting tooth and nail to keep such ratings systems down …

Even Angie’s List who claims to have physician reviews have remarkably few reviews. I’m not sure how you give patients anonymity (to assure honest opinions) while protecting them from a backlash from the physician and protecting doctors from people with an axe to grind.

I don’t have an answer for this problem, but doctors feeling like no one has the right to judge them is the first problem that will have to be dealt with.”