A column in the current New England Journal of Medicine raises again the prospect that deterring fraud and abuse might provide substantial health care savings. The article cites $60 billion as a conservative amount being wasted through fraud and abuse. The Bush administration had asked for additional resources to combat fraud, but Congress would not provide this funding. The current administration is similarly seeking more money to support antifraud programs. Medicare and Medicaid have either been particular targets of the defrauders or they have done a worse job than the private sector at rooting out fraud. For those who support a public insurance plan, it is worth noting that Medicare and Medicaid have a very poor history of innovation not only in this area, but in encouraging wellness and more appropriate care delivery by providers. In any event, the payback from enhanced antifraud programs is so great that it is hard to imagine why all needed resources aren’t devoted to the effort.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
What do you get when you combine a company with a commodity business model, that out of desperation massively overpays for another company that has a commodity business model? $10...
July 27, 2022
The “stupid” model for health care venture capital investing is alive and well. Everside health, which operates primary care clinics and has grown by acquiring other failing health care businesses,...
July 26, 2022
Apparently not even a cute name can save you if you have a stupid business. I constantly bemoan the mis-application of capital and health care is Exhibit A. Olive, another...
July 26, 2022
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace