The settlement last week of a significant lawsuit against Medicare now opens the door to increased treatments and therapies being provided to patients in their homes, and paid for by Medicare.
The specific change anticipated by the lawsuit involves a requirement that patients have some possibility of “improvement” in order for services to be approved for reimbursement by Medicare. In the future, the possibility of improvement will no longer be a consideration.
This is long overdue and will change the lives of millions of patients and their families.
First, receiving necessary treatment will slow the pace of decline even if the possibility of actual improvement does not exist. For people experiencing physical or cognitive impairment, receiving therapeutic services or treatments is at the very least compassionate. It is also financially wise, which brings us to the second major benefit:
Paying for several months or years of therapy for a loved one can be financially devastating for all but the most wealthy families. As a result, families experience the wrenching decision of paying for care for an elderly parent versus preparing the children for an advanced education.
It is also beneficial to society as a whole, because when our loved one declines to a certain point, we bring them to the emergency room where they are frequently admitted to the hospital, at a much higher cost, much of which may have been completely preventable.
Granted, some fear an explosion in fraud as providers of various skill levels rush in to provide, and bill for services. Fair point. But I for one am optimistic that as we move further into the world of information exchange and both electronic and personal health records, that services can be effectively monitored and that the impact of fraud will be far, far less than the benefit to patients, their families and society as a whole.
What do you think?