A New York Times article calls into the question efficiency of electronic billing to Medicare. It seems that fully automating billing also makes it easier to manipulate the billing process and thus maximize revenue for some hospitals and doctors. Ah, unintended consequences.
On the other hand, this is just an extension of what Medicare has always been doing; processing virtually all claims submitted with very minimal review for medical necessity, and appropriateness of services provided.
There is a very simple equation here:
reduced payments to health care providers=more incentives to raise revenue+low administrative costs=minimal oversight=fraud and abuse+higher costs
Ummm, I guess it’s not that simple, but it should be obvious. I wonder what will happen in the future as the thrust in saving Medicare is more cuts in provider fees?
9-22-12
QUINNSCOMMENTARY 