MediCaring.org : Why doesn't Medicare payment cover MediCaring services now?
MediCaring is needed because the current care system functions so badly for persons who are disabled with eventually fatal chronic disease. Most such persons rely on Medicare payment, and neither Medicare's fee-for-service nor its capitated risk approach allows providers to make a living if they tailor care to this population. Priorities for these patients include:
- correct medical treatment (especially prescription drugs),
- effective and prompt symptom prevention and management,
- comprehensive care,
- advance planning to handle complications without fear,
- customizing care to patient and family preferences and capabilities,
- protecting families from unreasonable emotional or financial burdens, and
- generally living well within the constraints of serious illness.
These services are not reimbursed well (if at all) in fee-for-service Medicare, though hospital-based treatments to rescue patients from episodes of worsened status are well-compensated.
Capitated managed care could avoid that problem, but the risk of adverse selection arising from a good reputation precludes expecting managed care organizations to tailor care to serve this population.