Medicare’s new way to pay docs shortchanges seniors
You’ve paid tens of thousands of dollars into the Medicare system throughout your life.
And you have every right to expect this government health plan to be there for you when you need it.
But if you need your knee or hip replaced, the Obama Administration is getting ready to roll out a program that would ask doctors… and your hospital… to cut corners with your care.
It’s a policy called “bundling” that sells out America’s seniors for peanuts. And it could risk your health — and safety — during the most serious surgery of your life.
That’s what health policy expert and former New York Lieutenant Governor Betsy McCaughey said about a Medicare plan that would pay one flat fee for joint replacements at more than 800 hospitals nationwide, starting in January.
It’s called the Comprehensive Care for Joint Replacement Program, and it will affect about a quarter of all patients getting knee or hip replacements.
But the treatment these seniors receive will be anything but comprehensive.
Right now, when you get one of these surgeries, Medicare reimburses your doctors and hospitals for every part of your care — from your X-rays to your anesthesia, right down to your stay at a rehabilitation center.
But under the new proposal, your entire treatment plan would be covered by one flat, heavily discounted fee.
The problem — as anyone who has ever managed a budget knows — is that if one part of your care costs more than expected, your doctors are going to have to find savings somewhere else. So if your surgery is more complicated than anticipated, your doctors may have to cut the number of days you can stay in the hospital or skimp on your physical therapy or rehab.
One analysis predicts that instead of recovering at a skilled nursing facility, you could be sent home under the care of a part-time health aide just to save Medicare cash. That’s especially dangerous, given the serious complications — like life-threatening blood clots — that can develop after a knee or hip replacement.
And some of the top hospitals and doctors in the country may even stop doing these surgeries for Medicare patients for fear of losing money.
“Bundling will make it financially risky for hospitals in New York and many other areas of the country to do hip and knee replacements,” McCaughey said.
And this discount bundling plan could get a whole lot worse very soon.
Dr. Ezekiel Emanuel — a health care adviser to President Obama and one of the architects of Obamacare — wrote in the Wall Street Journal that he envisions bundling eventually covering everything from heart stents to cancer treatments. Doctors would be paid “a discounted amount for the whole array of services.”
The worst part is that our government is selling out America’s seniors for chump change.
The Centers for Medicare and Medicaid Services is willing to subject thousands of seniors to shoddy care to get their knees and hips replaced, all to save a grand total of about $30 million a year.
Are you kidding me? That may seem like a lot of money, but this is the same government that was willing to shell out nearly $400 million for that “Bridge to Nowhere” in Alaska. And it’s a drop in the bucket compared to the $60 billion Medicare estimates was lost to fraud, waste, abuse and improper payments just last year alone.
Instead, our government is trying to save some pennies by penalizing innocent patients who need surgery in order to restore their mobility.
If you’re a Medicare recipient planning to have a knee or hip replaced, you might want to consider getting it done before the end of the year. Or if you have to wait, it’s a good idea to ask whether your hospital is going to be affected by this dangerous bundling plan.
While it looks like this treacherous plot is a done deal, you should still reach out to your representatives in Congress and voice your objection.
Sources:
“Medicare test would make hospitals bear risk for hip and knee surgeries” Virgil Dickson and Melanie Evans, July 9, 2015, Modern Healthcare, modernhealthcare.com
“Medicare funds totaling $60 billion improperly paid, report finds” Jim Avila, Serena Marshall and Gitika Kaul, July 22, 2015, ABC News, abcnews.go.com
