It turns out the pen is mightier than greedy doctors, too—and can lead to "unprecedented" savings for Medicare.
Six years ago, a damning magazine article revealed sky-high levels of unnecessary spending on Medicare patients in a Texas border town, where doctors were ordering excessive amounts of "almost everything—diagnostic testing, hospital admissions, procedures."
The article in The New Yorker exposed how Medicare recipients in McAllen, Texas, "received forty percent more surgery," nearly twice the amount of heart studies, and "five times the per-capita spending on home-health services" than in the comparable border town of El Paso, which had "half the per-capita Medicare costs and the same or better results."
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That gross disparity had a national impact: Medicare is a federal program, which mainly serves the elderly, and it was taxpayers who were bearing the costs of over-treatment in reimbursements to providers. It also underscored the potential for abuse of a health-care system that remains predominantly oriented toward "fee for service": doctors and hospitals being paid for each treatment they perform, instead of based on how well a patient does in terms of overall health.