Great News! Medicare Tightening Up At Last

Tom Emerick

Posted 4/3/12 on Cracking Health Costs

Good news on the Medicare front.  In a few states (FL, CA, MI, TX, NY, LA, IL) they are at last tightening up on unnecessary surgical procedures, according to a news story in Forbes.  Hurray!

According to the story, “In 2012 CMS will perform an audit before paying for several big ticket cardiology and orthopedic procedures in certain key states.”  All I can say is, at last.

This is huge news.  If Medicare takes this seriously, and gets the results it should get, it will be a great step forward in advancing evidence-based medicine in the public sector.  Further, it will pave the way for employer-sponsored plans to be more aggressive in dealing with over-surgery.  Readers of Cracking Health Costs know that I’ve been tough on Medicare for looking the other way over unnecessary surgery for decades.  May the day come when I can take it all back.

Predictably surgeons are unhappy.  Most surgeons have had no accountability to anyone for getting diagnoses right or doing surgery only when truly necessary.  They will vigorously resist such accountability.  However, such accountability is the norm in most industrialized nations.  That lack of accountability here is one of the main reasons why we spend so much more on health care than our peer nations but get worse and worse results.  Accountability needs to be the norm here too.

Plus Wall Street doesn’t like the idea either.  “Reaction to the report on Wall Street was immediate.  Hospital and medical device stocks plunged after the report was issued on Friday….”  Hmm.  My theory is Medtronic’s stock price is inversely related to America’s economic health.

This is a good test to follow as it is a battle between evidence-based medicine and profit-driven medicine. To see the full article, click here.

About Brian Klepper

Brian Klepper is a health care analyst and the Chief Development Officer of WeCare TLC onsite clinics.
This entry was posted in Analytics, Conflicts of Interest, Health Care Cost, Innovation, Medical Management, Physicians, Policy/Law/Regulation, Quality, Reform and tagged , , , , , . Bookmark the permalink.

One Response to Great News! Medicare Tightening Up At Last

  1. bev M.D. says:

    Since this new process supposedly started last January, we should have some data on its impact soon?

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