Medicare Rules Directly Jack Up Prices and Hidden Costs
Medicare rules limit access to local care. I learned this the hard way recently when I broke both wrists and needed home care.
Medicare Rules Cost Us Access to Care
For a healthcare business to accept Medicare patients (and it’s difficult to survive without them), it must comply with Medicare Conditions of Participation. These rules then apply to ALL patient care that the business provides.
Medicare enforces rules with financial penalties, regularly auditing patient records going back three years.
Surprisingly, Medicare auditors review any patient records regardless of payment source. All are fair game to evaluate and penalize businesses for noncompliance.
Case Study: Up-front Prices More Than Doubled
To regain independence after surgery, I requested Occupational Therapy (OT) to evaluate my home and recommend assistive devices, and a home health aide to assist with bathing.
The home care scheduler said that an RN or Physical Therapist (PT) had to do the admission visit. I agreed.
PT and OT had no recommendations to offer. The surgeon would not order OT exercises until three weeks later, recommending outpatient rehab.
However, Medicare requires OT, PT, or RN supervisory visits at least every 14 days in order to continue home health aide visits.
Hidden Regulation Costs
In addition to visit requirements, time and record-keeping burdens further inflate healthcare costs.
Medicare mandates home health aide licensing, initial training programs, competency evaluations, and specify twelve hours of in-service training per year.
These unnecessary Medicare regulations create barriers for individual care.
