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Perverse Incentives: Reimbursement and Bilateral Surgery

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Perverse Incentives
Perverse Incentives: Reimbursement and Bilateral Surgery, in the text (Buchbinder, Shanks, & Buchbinder, 2014)
• Create a list of legal and ethical concerns you would have as a health services manager in this situation.
• Discuss what regulation requirements may be most problematic (include consequences).
• Presume the surgeon, hospital billing department, and senior leadership will not change current practices. Suggest a rational course of action to minimize risk and maximize reward without jeopardizing network or provider contracts.

amit the discussion questions from PDF file. I need help with this

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Solution Summary

Perverse incentives for reimbursement and bilateral surgery are analyzed. The regulation requirements may be most problematic (include consequences) is discussed.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195102/

http://www.healthline.com/health/varicose-vein-stripping#Recovery6

ethical concerns Perverse Incentives: Reimbursement and Bilateral Surgery, in the text (Buchbinder, Shanks, & Buchbinder, 2014)

• Create a list of legal and you would have as a health services manager in this situation.

As the health services manager in this situation, (you) would have the responsibility to provide the highest quality of care for the patient and uphold the hippocratic oath to do no harm to the patient. After reviewing the common procedural approach taken by physicians who conduct this surgery, I believe that choosing to do two separate surgeries is not within the vested interests of the patient, but is rather within the financial interests of the physician. The physician should never place the interests of themselves over a patient, and because the physician has an incentive to conduct surgeries on different days as a result of the pay scale that only pays 100% for the ...

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