Cumberland Times-News

Editorials

May 13, 2014

Spendthrift

Medicare wastes money overtreating patients

Another example of the government’s willy-nilly spending of tax dollars is illustrated in a report published Monday in the Journal of the American Medical Society.
The study — which stems from a 2009 analysis of Medicare claims for 1.3 million patients — concludes that up to 42 percent of patients got at least one medical procedure they did not need. The overtreatment may have cost the government — or, more accurately, we taxpayers — as much as $8 billion.
The researchers devised a list of 26 “low-value” procedures they determined reflect likely overuse. The list was compiled from research evidence and recommendations from several medical groups.
The AMA Journal said lead author Aaron Schwartz of Harvard Medical School’s health care policy department and colleagues acknowledged that Medicare claims may lack details about patients that might justify some procedures. But using more conservative criteria, they still found that 25 percent of patients received at least one wasteful service, totaling almost $2 billion.
The questionable procedures include prostate cancer screening for men beyond the age most experts recommend the tests; too-frequent imaging osteoporosis tests for women; questionable invasive heart and kidney procedures; and cement implants for back pain patients who gain little or no benefit from the procedures.
The findings are bad news for Medicare, especially since they follow another study released last month by the government detailing Medicare billing records for 880,000 health care providers. That data revealed vast differences in Medicare payments, and an agency administrator said Medicare would look into doctors and others who received huge reimbursements, which could suggest overtreatment.
Congress should follow up on this latest news that many Medicare procedures should not be ordered by doctors in the first place. The AMA Journal said the study it published is only a snapshot and the researchers said there are likely many other procedures that are sometimes performed with little benefit for Medicare patients.
Who knows what else will be found if congressional investigators start digging?

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