Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Fraud' Category

Why Reducing Waste is Difficult

Identification of waste is difficult, but eliminating it is more difficult. Every dollar of waste is income to some individual or organization. – Victor Fuchs, from “Health Care Reform in the United States“

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The Start of Rationing in Medicare?

Prior authorization is a common tool that managed care organizations use to reduce patient utilization of medical services.  Some physicians believe that prior authorization creates barriers to effective care, but other commentators believe that prior authorizations can be implemented in a more efficient manner.  Either way, prior authorizations are a form of rationing care. Although […]

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Is Medicare moving towards rationing your medical equipment?

Currently, Medicare fee-for-service (FFS) beneficiaries receive significantly more choice than standard commercial plans.  They can choose any provider they wish (who accepts Medicare).  There are no cost-sharing differences between in-network and out-of-network doctors (because there is no ‘in-network’ for Medicare).  Although certain Part D prescription drug plans require prior authorization for specific drugs, few services […]

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