Narrative Matters: On Our Reading List

Editor’s note: “Narrative Matters: On Our Reading List” is a monthly roundup where we share some of the most compelling health care narratives driving the news and conversation in recent weeks. Cut Off From Ambulance Rides In December 2014, Medicare began a pilot program in Pennsylvania, New Jersey, and South Carolina to require prior authorization for “repetitive, scheduled, nonemergency” ambulance rides — enforcing a long-standing Medicare policy under which beneficiaries needed to require a stretcher before Medicare would pay for the nonemergency rides. But the policy crack-down left Charles Prozzillo, and others like him, with few alternative options for transportation for medical care. In a story for Philly.com, Kaiser Health News reporter Lisa Gillespie explores the reasoning behind the pilot program—to cut down on improper payments, including fraud and abuse—and its unfortunate consequences for patients. After Medicare stopped paying for Prozzillo’s ambulance rides to and from dialysis, his wife and daughter took turns driving him, but while getting out of the car in his driveway one day, he fell and broke a hip. He died not long after. “There should have been another alternative for him,” his daughter says. “He would have lived longer.” CMS expanded the pilot program to the District of Columbia, Delaware, Maryland, North Carolina, Virginia, and West Virginia in 2016. While Medicaid pays for nonemergency wheelchair van transport, ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Equity and Disparities Featured Medicare Narrative Matters Quality big data On Our Reading List Source Type: blogs