Medicare rewards MDs for overuse
Martes, 9 de Febrero de 2010
By Julie Steenhuysen
Reuters
CHICAGO – Medicare’s move in 2005 to pay doctors to do bladder cancer surgery in their offices rather than in hospitals dramatically raised the number of procedures and overall health costs, U.S. researchers said Monday.
The findings reflect the complexity of cutting health costs in the United States, showing how in some cases Medicare – the insurance program for the elderly and disabled – gives doctors incentives to provide too much care, they said.
Cutting costs and improving access for millions of Americans now without health insurance are major aims of President Barack Obama’s efforts to overhaul the U.S. healthcare system but the legislation is stalled in Congress.
“It’s incredibly complicated,” said Dr. Micah Hemani, a bladder cancer expert at the New York University Langone Medical Center, who studied changes in treatment patterns in his group practice before and after the pay hike.
“What we found based on our billing data was that the number of procedures dramatically increased without a decline in the number of hospital-based procedures,” Hemani, whose study appears in the journal Cancer, said in a telephone interview.
“If you adjust for the growth of our practice and you are doing more of these procedures but your hospital-based ones don’t decline, you are spending more money.”
Bladder cancer is the most expensive of all cancers to treat, with an average cost from diagnosis to death ranging from $96,000 to $187,000, according to Hemani and colleagues.
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