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THE BREAD WINNER BLOG

entrepreneur makes millions teaching companies to outsmart obamacare

1/19/2016

 
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America's $3 trillion health care industry is incentivized toward bad behavior. Most billable procedures rely on volume to turn a profit, according to Lack. A doctor might bill for a procedure, but not for activities that would have prevented that procedure. As a result, hospitals that make money every time you visit have little incentive to remind you to take the meds that might prevent a visit in the first place.
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An entrepreneur is helping corporate CFOs win against the government.  Craig Lack, a healthcare consultant, makes millions showing companies how to find loopholes in "Obamacare" which is officially known as the Patient Protection and Affordable Care Act (PPACA), or Affordable Care Act (ACA) for short. 

The INC article mentions that healthcare providers gain more from diagnosing and treating chronic illnesses than they do from preventing those same illnesses.  Read the article here. 
As a caregiver here are a few things you can do to ensure that your loved one is not being billed for unnecessary medical services:
  1. Time all procedures yourself.  Medical office, operating room and anesthesia time are generally billed in 15 minute increments which can add up quickly.  Review your time in and out of all appointments and procedures to ensure accurate billing of time.
  2. Watch out for up-coding.  A hospital could inflate your loved one's diagnosis to one representing a more serious procedure, leading to a higher medical bill. For example, your loved one could have received the lowest of emergency room services but be billed at the highest level. This is an illegal, fraudulent practice and you should ask your health care provider to correct the charge immediately.
  3. Just say "No." to unnecessary medical tests.  Tests like MRIs and CT Scans for lower back pain or routine Prostate exams are unnecessary.  Many healthcare providers continue to recommend, perform and thus bill for unnecessary medical tests.  Before any medical procedure discuss with your provider the reasoning or their recommendation and the necessity of the procedure.  

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Photo used under Creative Commons from Rennett Stowe
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