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Minimizing Waste in Health Systems

Submitted by Spencer Chenoweth | 11 Dec, 2015

Extend medicare's coverage to cover observational study time. Observation studies are a loop in medicare coverage where a patient can be asked to stay at a hospital for up to three days. Medicare does not cover the costs from this time. Typically those on medicare cannot afford a three day stay in the hospital, with all of the costs of medicines, that in some cases are everyday medicines that the patient regularly takes, but have to pay enormous amounts for at the hospital. Observational studies, should either be eliminated to avoid situations where patients are getting services they cannot afford; or medicare should adapt to cover this time period.

Packaging and shipping of medical goods should be restructured to where items needing refrigeration should be shipped to pharmacies, so that patients can then pick them up at the pharmacy. This is instead of shipping to patients with multiple ice packs and excess shipping materials to individual patient. It just adds extra waste to the system.

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Bruce Landon Advisor Replied at 4:52 PM, 11 Dec 2015

As noted in this post, Medicare is not a uniform insurance program, but rather a collection of several disconnected programs. Nowhere is this more evident than in the care for patients being seen in hospitals. In its efforts to decrease over-utilization of the hospital, Medicare has encouraged patients to be cared for as outpatients. While this is a laudatory goal, it often puts clinicians in the uncomfortable position of needing to care for patients requiring more intensive monitoring than they can receive at home without officially hospitalizing them. In reality, these patients, who are admitted under observation status, get largely the same care as if they were fully admitted. Unfortunately, however, because they are not officially admitted, they are required to cover the 20% co-insurance associated with Medicare Part B coverage. This results in large out of pocket payments for beneficiaries who lack other coverage (e.g., a Medicare supplement or Medicaid), and, often, these costs are not disclosed. I believe that a more comprehensive solution is needed than that above. As Alice Rivlin, Karen Davis, and others have suggested, Medicare needs to be changed to a more unified program with combined deductibles and a more modern benefit package, which would cap the amounts of copayments in situations such as the one described above and alleviate much of this problem.

This Community is Archived.

This community is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.