South Carolina Medicare Fee Schedules - How Does it Affect the Care You Receive?
With all the talk this year of health care reform, the effects of fee schedules on the care individuals receive has been a major point of discussion.
Currently, Medicare uses a fee schedule to define what doctors and hospitals get paid per treatement or procedure. What this means is there a set amount that doctors and/or hospitals receive. There are two schools of thought on this. While it is unquestionable that this eliminates confusion and creates some standardization in the system, some feel that it opens the system to possible corruption and abuse. Some of the arguments against the system being set up this way are:
1. Doctors or hospitals, when choosing a treatment, can choose the more expensive treatment on the fee schedule. While this is true, the same would be true if there were no fee schedule. We all rely on the integrity of doctor to "first do no harm", to our bodies or our pocketbooks.
2. The fee schedule does not accurately reflect what doctors should or could charge for procedures or treatments. This is an argument made by some doctors, who say that fee schedules do not accurately portray what costs should be. Many claims that, since they are the ones trained in medicine and particular treatments, they should be the ones to define the costs.
3. The fee schedule causes some to get too much, or too many, treatments. This argument just says that, since doctors or hospitals know the actual reimbursement rates and know that there is not close regulation of the system, they are apt to perform more procedures than necessary. Again, reliance on doctors integrity and honesty is the protection we have against this. Without a doubt, there could and should be more regulation on treatments that Medicare patients receive to monitor this kind of corruption and abuse.
While some of the health care reform proposals have discussed the fee schedule system, this is an entrenched system that is probably going to be revised, more than overhauled. However, by focusing on regulating the use of the system by doctors and hospitals, most believe much of the waste and abuse can be eliminated or reduced.
Currently, Medicare uses a fee schedule to define what doctors and hospitals get paid per treatement or procedure. What this means is there a set amount that doctors and/or hospitals receive. There are two schools of thought on this. While it is unquestionable that this eliminates confusion and creates some standardization in the system, some feel that it opens the system to possible corruption and abuse. Some of the arguments against the system being set up this way are:
1. Doctors or hospitals, when choosing a treatment, can choose the more expensive treatment on the fee schedule. While this is true, the same would be true if there were no fee schedule. We all rely on the integrity of doctor to "first do no harm", to our bodies or our pocketbooks.
2. The fee schedule does not accurately reflect what doctors should or could charge for procedures or treatments. This is an argument made by some doctors, who say that fee schedules do not accurately portray what costs should be. Many claims that, since they are the ones trained in medicine and particular treatments, they should be the ones to define the costs.
3. The fee schedule causes some to get too much, or too many, treatments. This argument just says that, since doctors or hospitals know the actual reimbursement rates and know that there is not close regulation of the system, they are apt to perform more procedures than necessary. Again, reliance on doctors integrity and honesty is the protection we have against this. Without a doubt, there could and should be more regulation on treatments that Medicare patients receive to monitor this kind of corruption and abuse.
While some of the health care reform proposals have discussed the fee schedule system, this is an entrenched system that is probably going to be revised, more than overhauled. However, by focusing on regulating the use of the system by doctors and hospitals, most believe much of the waste and abuse can be eliminated or reduced.
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