Dazzling incompetence

[dmn23]

I work for a company that processes Medicare claims. Part of our job includes posting fee schedules. Per CMS (Centers for Medicare & Medicaid Services):

A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. CMS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies.​

And every quarter the fees get revised. So we're clear, that means the amounts that CMS publishes the first time around are incorrect. EVERY GODDAMNED QUARTER. And I've been working this job since the end of the Clinton administration.

I honestly cannot begin to fathom the cost of these revisions for every carrier and every provider and every supplier in the country. Does anyone think for a moment those costs don't translate into higher healthcare and operational costs?

That sort of incompetence is breathtaking to me.

</rant>

 

[Denverdave]

I would really like to think that kind of stupidity is limited to the Federal/state governments. But I have seen it equally bad in the private sector. With new management best selling books and systems coming out every month you would think that we have developed a brilliant management culture in this country in both the public and private sector.

Nope.....

 

[mongooz]

if people and companies and gov't entities were efficient.....more than half the jobs in this country would cease to exist, possibly including yours and mine.

just a thought.

(yea i get that things cost 5 times more than they should, if folks would just do their job right.......the first or even second time)

 

[dmn23]

(yea i get that things cost 5 times more than they should, if folks would just do their job right.......the first or even second time)

But the effects actually stretch well beyond the cost implications for a particular good or service. If I'm having to spend countless hours doing the same job over again then those are hours that aren't being devoted to elsewhere to innovation, process improvement, QC, etc. It's fucking crazy-making.

 

[Stratguy]

Working in any field where you work with the government and private firms, it is mind boggling the amount of insane regulations and hoops that you have to jump through with the government vs. everyone else.

 

[Chad]

People are idiots. It is amazing how inefficient companies/governments are.

 

[tiger roach]

I'll file this one under "Disappointing/Distressing, but Not Surprising."

 

[OGG]

Well, regardless of the affect on the overall financial strain it places on the patient, I think we can all agree that it's far more important to know the exact cost up front in order to avoid surprises.









Dick post #4.

 

[ColourofFire]

I would really like to think that kind of stupidity is limited to the Federal/state governments. But I have seen it equally bad in the private sector. With new management best selling books and systems coming out every month you would think that we have developed a brilliant management culture in this country in both the public and private sector.

Nope.....

Yup, I really hate the privatisation mantra of "corporate is more efficient". I've worked at the privatised postal company in the Netherlands, waste of resources seemed to be core business at that place. Hell, pretty much everywhere I worked made huge efforts to improve efficiency and all it caused was time squandered on meetings, training and whatever and very little actual improvement.

 

[BlockInlay]

I work for a company that processes Medicare claims. Part of our job includes posting fee schedules. Per CMS (Centers for Medicare & Medicaid Services):

A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. CMS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies.​

And every quarter the fees get revised. So we're clear, that means the amounts that CMS publishes the first time around are incorrect. EVERY GODDAMNED QUARTER. And I've been working this job since the end of the Clinton administration.

I honestly cannot begin to fathom the cost of these revisions for every carrier and every provider and every supplier in the country. Does anyone think for a moment those costs don't translate into higher healthcare and operational costs?

That sort of incompetence is breathtaking to me.

</rant>

Are the revisions actually cost adjustments (e.g. inflation, market changes) or are they errors? Or maybe a combination of both?

 

[GilmourD]

People are idiots. It is amazing people don't earn Darwin Awards en masse every our on the hour.

FTFY

 

[instantsteve]

I work for a company that processes Medicare claims. Part of our job includes posting fee schedules. Per CMS (Centers for Medicare & Medicaid Services):

A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. CMS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies.​

And every quarter the fees get revised. So we're clear, that means the amounts that CMS publishes the first time around are incorrect. EVERY GODDAMNED QUARTER. And I've been working this job since the end of the Clinton administration.

I honestly cannot begin to fathom the cost of these revisions for every carrier and every provider and every supplier in the country. Does anyone think for a moment those costs don't translate into higher healthcare and operational costs?

That sort of incompetence is breathtaking to me.

</rant>

Single payer.

 

[Tiltsta]

You should spend a little time working with The National Institutes of Health if you want a perfect picture of inefficiency. It takes 6 months for them to review grant proposals, and another 6 to actually fund the 4% or so they can afford to fund. It then takes another 6 months to see the money, as they are operating under a continuing resolution as Congress can't pass a budget, so payments are delayed. If you are not in the 4%, you start over. In the meantime, your competitors in Asia or Europe publish the study, and their final decision is that no money is needed for the research because it was just finished. No money coming in means labs close, people get fired, and we move another step further away from curing cancer.