The Fine Line Between Tech-Enabled Process and Fraud
Smart phones, rising Medicare bills and finding senor housing
By Laurie Orlov
Smart phone plans: a super-sized way for carriers to make a buck. McDonald's now has to tell you the calories in a Big Mac, but Verizon and AT&T don't need to warn you that watching videos on your phone will suck up the monthly minutes on your data plan faster than a vacuum cleaner picks up dirt. So while only 11 percent of the 65+ have smart phones, they are part of the 50% of households that have one or some. Instead of being told upload-download speeds and the storage capacity on the phone, and how to video conference the whole family in on a call, how about giving you a WARNING sheet that shows price equivalents (like calories) of the various activities you think you want -- and how these activities fit into or drive up charges beyond your data plan? How about handing you a sheet that outlines all hidden costs? If that doesn't make you blink, then ask what percentage of customers exceed these plans and what the average monthly bill is for customers with the type of phone you're considering? And if that data doesn't make you blink, you obviously can afford to both buy dinner and own the phone.
Medicare bills rising with automated records - don't you love it? A technology that should have lowered Medicare bills has had the opposite effect. The technology now provides an opportunity for 'up-coding' a higher level of service than that which was provided. It also provides for 'cloning' in which the diagnosis/treatments of one (presumably up-coded) patient is copied to the record of another. Medicare, which pays first and reviews later, (how is that for a fraud invitation?) is being billed 47% more by the organizations that have implemented EMR than the ones who have not. (This data is just through 2010.) Luckily, EMR implementation, particularly in doctors' offices, is still not at the half-way point, even with the financial incentives, so there is, uh, room for improvement. One of the barriers, if you can call it that, is the change in workflow - my recent doctor's visit is a case in point - after he struggled his way around the multiple screens of my EMR, read aloud my previous visit information and tests, etc., we could get down to the current visit - for which he entered more requests for this year's tests, listened to my heart and I left. Is this good care?
Last but certainly not least - tools for finding senior housing. The FTC cracked down this week on overstatements by two companies on the extent of actual research they claimed to do about assisted living. It would be nice if this were a compelling warning to existing and new companies that help with the search for home care, assisted living, and other services for seniors. People believe what they read online - even when it isn't true. The FTC isn't the real problem here - they will never research all of the claims of extensive research, due diligence, knowledgeable consultants, free services, pay-for-play reviews that are the bread and butter of the online search tools. Once in a while, practices are exposed as in the Seattle Times effort last year. But for the most part, at the most desperate and needy time in family life, looking for senior care for your parents, you want to believe. And the barrier to entry for new businesses? Need I say - it's the Internet?
Published October 4, 2012