Carter Wrenn posted on October 10, 2009 19:37
The gray-suited factotums and Grand Vizier’s over at the DHHS headquarters on the old Dorothea Dix Campus have come up with a new mantra: ‘We’re going to give patients what they need, not what they want.’
That sounds reasonable until you get past the ‘spin.’
Let’s say for simplicity’s sake there are two kinds of people who work in health care: The nurses and doctors and nurses aides who sit by beds and care for patients, and the administrators who sit in offices and manage health care programs for DHHS.
CCME is an example. CCME is a private company. DHHS pays it to manage North Carolina’s Home Care program. There are a lot of other private companies – like CCME – who manage health care programs for the state and when it comes to getting state contracts they’re wired into the Department of Health and Human Services like the military-industrial complex is wired into the Pentagon.
CCME’s main work is reviewing providers’ record keeping, interviewing patients then reporting back to DHHS.
CCME just renegotiated its contract with DHHS and received a 29% pay increase for its patient interviews.
At the same time DHHS just cut what it pays the people who provide home care to elderly patients 4.9% .Meaning the brunt of the cuts will be borne by home care aides who work by the patient’s bedside – instead of managers who don’t provide care to anyone.
If a CCME manager interviews just two patients in a day – and they will interview thousands of patients – those two interviews at $450 a piece will cost the state more in one day than what it costs the state to cover an entire month of services for the average patient.Now why is CCME’s fee going up from $350 to $450 for each patient ‘interview’ – while the folks providing care are being cut?
Well, DHHS Secretary Lanier Cansler’s former lobbying partner is a consultant with CCME. Maybe that’s just an accident. Or coincidence. But, either way, it doesn’t look good. And it certainly looks like an example of a health care management company snuggling up to the folks in DHHS who grant the contracts.
Whatever the reason, money’s tight at DHHS and when they spend more on managers – like CCME – it means spending less for care. So, CCME’s new contract cuts the ground out from under DHHS’s new mantra.
It’s not giving patients the care they need instead of what they want.
Instead, what it’s really saying is, We’re going to give patients the care we want them to have – and if it’s not what they need they’ll just
have to adjust