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Controlling costs for prosthetic care.

June 19, 2019

Recently a patient called us with a question about his explanation of benefits from Medicare. He is concerned that Medicare is going to run out money in the not-too-distant future and about allegations the government has made about the amount of Medicare fraud, and he was questioning the cost of the care  we provide, which included a prosthesis and a pair of shoes. Hats off to him for being a good citizen! If every person took as much of an interest in the fiscal health of this country as he does, we might not have as many challenges as we do. However, there are several things that need to be stated in response to his concerns.

 

First, as a practitioner of prosthetic care for over 30 years, I can tell you that the predictions of Medicare's demise have been around for a very long time, and yet, somehow or other, good sense always seems to prevail and Medicare goes on. Could Medicare go broke? Yes, it's possible. But if past history is any indicator, it won't.

 

Second, CMS (Centers for Medicare & Medicaid Services) sets the fee schedules for charges from practitioners like us. In other words, we charge what they tell us to charge. In theory, the system is designed to limit the likelihood of fraud by setting a consistent schedule of fees that all providers must adhere to. Again, that doesn't mean fraud doesn't happen. But with individual practices, it's very, very unlikely. It may be more likely to occur higher up in the system, where the negotiations over fees take place. And we don't have much of a seat at that table.

 

Finally, at AtlanticProCare, we are actively working every day to keep costs DOWN for our patients. With innovations like our Rapid Ambulation Method, which provides a new prosthesis in one visit, and Virtual Visit, which allows amputee patients to be treated remotely via the internet, we have saved patients hundreds of hours of travel time and inconvenience and reduced the costs associated with the provision of care. And you can rest assured that as long as Medicare is around – or predictions of its demise are – we're going to be looking for new ways to make the care we provide more convenient and less costly.

 

 

 

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