The conceptual map demonstrates that an overused service can lead directly to short- and long-term negative consequences for patients. This appeared in the article, “Development of a Conceptual Map of Negative Consequences for Patients of Overuse of Medical Tests and Treatments,” JAMA Internal Medicine, October 2018. It is reproduced here with permission of JAMA Internal Medicine.
It’s easy to understand the economic arguments against exposing people to medical treatments and tests that many experts say are unlikely to help them. But it’s been tougher to quantify medical reasons for avoiding what researchers call “low value” care.
A paper published July 23 in JAMA Health Forum may bring more clarity to the discussion.
About 1% of admissions for certain procedures widely considered to be of low value were linked to subsequent complications such as infections, foreign objects left in patients, falls and bedsores, wrote the authors of this paper, “Adverse events and hospital-acquired conditions associated with potential low-value care in Medicare beneficiaries.”
“To our knowledge, this is the first study to estimate hospital-acquired harms for U.S. Medicare beneficiaries associated with low-value care,” the authors wrote. Continue reading
There’s been a small flurry of stories and news updates on telehealth this summer.
On July 26, some 430 health systems, associations and companies sent a joint letter to Congress urging policymakers to extend telehealth benefits for Medicare beneficiaries beyond the COVID-19 public health emergency.
Prior to the start of the pandemic, Medicare only covered telehealth visits for its beneficiaries living in defined rural areas who initiated the call from a provider’s office, according to Kyle Zebley, vice president of public policy for the American Telemedicine Association (ATA), which is co-leading the effort. Thanks to provisions covered by legislation such as the Coronavirus Aid, Relief, and Economic Security (CARES) Act, telehealth became a covered service for all Medicare beneficiaries regardless of area of residence or where calls were initiated. But it was designed as a temporary measure. Unless it’s made permanent, cautioned the ATA and other letter writers, Medicare beneficiaries and providers who have become accustomed to the service could fall off what advocates call a “telehealth cliff.” Continue reading
To the uninitiated, Medicare, Medicare Advantage (MA) and Medicare supplement plans can seem simple enough: Medicare covers 80% of hospital and physician costs and MA and supplement plans cover the rest.
But in reality, Medicare and its associated additional plans can be incredibly complex to navigate. This is one of many lessons that Kate Yandell has learned since 2018, when she began reporting on Medicare beneficiaries’ financial challenges after a cancer diagnosis. Continue reading
It’s still difficult for many eligible older adults in parts of the U.S. to get COVID-19 vaccination appointments. And that’s exactly what con artists are counting on.
The Centers for Medicare & Medicaid Services (CMS), the Federal Bureau of Investigation (FBI), and the Department of Health and Human Services Office of Inspector General (HHS-OIG) are warning the public — especially elders — about several fraud schemes related to COVID-19 vaccines.
A screenshot from a television ad on Friday for a Medicare Advantage plan from UnitedHealthcare.
Watching the TV ads during the evening news, you would think Medicare Advantage plans were the greatest health insurance bargain ever invented. Consumers should not be fooled, however.
It’s true that the federal Centers for Medicare and Medicaid Services made it possible for Medicare Advantage (MA) health plans to offer more benefits to seniors enrolled in Medicare. Some of these plans offer coverage for vision, hearing, and gym memberships) while not charging a monthly premium, and some MA plans will even pay for seniors’ Medicare Part B premium, said John Barkett, a senior director of policy affairs at the health care consulting firm Willis Towers Watson. Continue reading