Many areas we work in have the same agonizing path:
1. Congress passes a law
2. People find a loophole
3. People exploit the loophole
4. Congress makes an attempt to close loophole
5. Loophole exploiters yell: "The sky will fall" and "That's not fair"
6. Congress does nothing
1. Congress passes a law
2. People find a loophole
3. People exploit the loophole
4. Congress makes an attempt to close loophole
5. Loophole exploiters yell: "The sky will fall" and "That's not fair"
6. Congress does nothing
Today's example
1. Law passes that pays Medicare Advantage plans more when covering sicker patients
2. Plans figure out how to make patients look sicker
3. Plans upcode, costing 20 bln/yr
4. Congress authorizes CMS to fix
5. Plans complain
6. Political appointees @ CMS do nothing
1. Law passes that pays Medicare Advantage plans more when covering sicker patients
2. Plans figure out how to make patients look sicker
3. Plans upcode, costing 20 bln/yr
4. Congress authorizes CMS to fix
5. Plans complain
6. Political appointees @ CMS do nothing
As detailed here...
healthaffairs.org/do/10.1377/hbl…
healthaffairs.org/do/10.1377/hbl…
