Better quality senior care possible through Medicare reform
An important component of providing the elderly with accessible health care is Medicare. The availability and quality of this care is affected by a number of factors. The reality of the relationship between Medicare and its providers suggests that at times, efforts made can be counterproductive.
Similar to any insurance company, Medicare reimburses clinics and hospitals for the services which are provided to patients who are covered by their policy. Health care providers currently are reimbursed on a fee-for-fee model; in other words, any treatment, medical service or medication is billed as a separate item which gets paid by Medicare.
While this may be a straightforward method for billing, it tends to get expensive quickly due to the way in which medicine is practiced. Because Medicare is a service which is publicly funded, it is in the best interest of the US Department of Health and Human Services that the billing process is streamlined and made efficient and that affordability and the quality of care are balanced out. In order to do so, the department has announced a plan to move away from the current model of billing and to focus on a qualitative approach to health care.
According to the Washington Times, a number of individuals find problems in the fee for service model used at present. Providers are reimbursed based simply on the number of procedures and tests performed throughout the treatment course rather than being based on the outcome and result of the treatment. This can thus unfortunately cause expenses to rise without the accountability of health care providers increasing.
According to the president of the American Action Forum Douglas Holtz-Eakin, the first step towards recovering is to admit that a problem actually exists. The fee for service by Medicare isn’t something which encourages good quality care but instead is a way to waste money. Other payment methods such as the bundled payment or the Accountable Care Organizations may do a better job and help the health care industry place an emphasis on getting results than only using various options for treatment.
While the desire to leave the current model behind has been stated, no decision has been taken with regard to any alternatives to be made use of. The Accountable Care Organizations however does seem to be a good option. As it was pointed out by the US Centers for Medicare and Medicaid Services, ACOs are those groups of nurses, doctors and other providers who work on providing a high quality of care to patients who are in need. Such coordinated efforts are usually more efficient and cost effective at delivering treatments because they make use of the expertise of a number of practitioners while at the same time avoiding oversight and redundancies which include duplicating tests and procedures which could prove to be quite costly.
Another alternative is that of bundled care initiative in which health care providers are grouped into 1 of 4 categories depending upon the service provided by them. Reimbursements are also made based on these categories instead of each provider being reimbursed separately.