In the health care sector, wasteful spending is rampant. Squandering financial resources can cost billions of dollars every year, and it’s not just in hospitals or with prescription medications; it’s also affecting home care. While pharmacies may deliberately increase the size of bottles beyond what’s needed to maximize sales, they can also cut short certain medications as a way to double sales unnecessarily.
Home care aides provide an invaluable service to men and women who have difficulties at home, often following a hospital stay or other serious health issue. While oversight has been a problem through the years for home care agencies and independent caregivers, there have been changes. Unfortunately, some of the proposed changes coming forth, such as the scuttled plan to require approval and more documentation for agencies before submitting billing to Medicaid, have led to fierce pushback from the industry in general.
As reported by NPR (National Public Radio) in its blog, A Prescription [t]o Reduce Waste [i]n Health Care Spending, written by Marshall Allen:
“It’s possible to reduce or eliminate some of the waste, but there are also formidable forces that benefit from it. Excess spending generates revenue and profit for what some have called the “medical industrial complex,” said Dr. H. Gilbert Welch, professor of medicine at the Dartmouth Institute for Health Policy & Clinical Practice. “There are a number of people who can imagine ways to solve things,” Welch said of the wasted spending. “But the political will and the forces at work can stop them pretty easily.”
Still, wasting fewer health care dollars could drive down insurance premiums and out-of-pocket costs and maybe even free up resources for education, retirement and wage increases, among other things.”
In most cases where fraud is concerned in home care, it involves Medicaid spending. There are few legitimate agencies who are firmly entrenched against the idea of increased oversight and regulation to improve access to and quality of this level of care, but with razor thin profit margins already, the increased paperwork associated with some regulations can be devastating for small, independent companies.
Fraud and wasteful spending hurts all involved in the home care industry and it ultimately impacts taxpayers and those who need this level of care most. The answers are difficult and solutions complicated and many with decades of experience in this industry would agree with that sentiment. However, the question remains how to provide quality care and sufficient access to adequate care without continuing to mirror some of the costly challenges raising costs throughout the healthcare industry?
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