How Ideas From Private Industry Help Combat Medicare Fraud, Waste, And Abuse

Health Affairs: May 23, 2013

It is increasingly well-known that improper payments cost taxpayers as much as $50 billion each year. These include reimbursements for billing for non-existent patients, falsified diagnoses, non-covered procedures, services not rendered or simply upcoded, as well as billing errors in favor of providers. Steps are being taken to address these issues through increased acceptance of approaches, tools and techniques from private industry and from industries outside of healthcare. More than just technology, some of the most powerful ideas to come along are that incentives matterdecentralization may achieve results faster and better, and stretch goals are crucial.  Read more