Follow the money: Patient health suffers from ill-advised, unnecessary treatments

Medicare spending on skin substitutes is not just a paperwork problem. Real patients who were Medicare beneficiaries suffered gravely due to treatments that didn’t work or that weren’t needed in the first place. Advocacy organization Accountable for Health has documented some of those examples, and CEO Mara McDermott, JD, discusses them here.

Medical Economics: Accountable for Health has compiled some stories about actual patients involved in these treatments. I don't want to delve too much into human suffering, but there is a real human cost. Can you talk more about that?

Mara McDermott, JD: It is incredibly upsetting. I would say there are stories on our website, and the press has covered some stories. The probably most horrific one that we have on the website is relates to a patient who whose wound became so badly infected that it became infested with maggots, and ultimately that patient had to have an amputation. The accountable care organization care team believes that that amputation was likely preventable, and it's hard to imagine worse outcomes than that. As I mentioned, we also have a patient in Colorado who passed away. This patient had had a wound that was well-managed for over 13 years. She moved to be closer to her family. When she moved, she became the victim of a mobile wound care clinic, and then within two weeks, her wound went septic and she passed away. So some really awful patient outcomes, which I feel like has been one of the factors that has really driven a lot of the policy change around skin substitutes, and certainly has motivated the accountable care organizations who, at the end of the day are here to try to deliver better patient health outcomes. And we're really seeing these patterns where patients were not getting better. In fact, their wounds were getting way worse.