Is the Quality of Medicare Medical Care Improving?

By Rich Weiss
Independent Insurance Agent

This has been an interesting question and is being considered from all points of the spectrum. Such a simple question with so many variables can support almost any conclusion.  One of the biggest problems with answering the question is what each person considers as improvement.  From a financial standpoint, CMS is driving reimbursements down which should lower costs, and in many cases, the flip side of the coin hurts the health system’s profitability.

If you are a physician who is not part of a health system, you are likely feeling the pinch.  If you are a health system that is reimbursed not only by what services you provide, but how well you provide them, then you are forced to invest in better patient care; and isn’t this what should drive health care anyway?  This is where it gets interesting as it depends on what you want as an outcome.  A patient wants care, and a doctor/hospital/network needs both quality care and a profit. That is how they stay in business.

Many of the latest studies in the health care industry are realizing improved patient care.  This is attributed to the large investment in compliance after discharge from a hospital or home outreach by both the hospitals and their insurance providers.  This is where the balance comes in — how much profit is willing to be lost to increase patient care.  Healthcare is a “widget” a “thing”, if you will, but make no mistake, it is a business and a very large business at that.

Transparency is the buzz word of the day and it is important to know what service costs, so you the consumer, can make an educated decision when it comes to your care.  One of the big problems is many providers do not know the true cost of a service or procedure, so they guess.  There are currently people working for the Cleveland hospital systems trying to figure out just that – what does this truly cost?  So in my humble opinion the only answer to such a complex question is this:  If you think it is better, it is and if you think it is worse, you are right again.