The decoding of the human genome is one such advancement, achieved in the year 2000, allowing the world to read the complete set of human genetic information for the very first time. The decoding set the foundation for discovering what the approximate 23000 genes in humans do. In the 1990s, mapping the human genome became a race between two competitors in the forefront. The government-funded Human Genome project was one, and a private company by the name Celera Genomics was the other. The Human Genome project was funded with more than $3 billion 1 in taxpayers’ money whereas the Celera Genomics project was financed with $100 million and the project was completed in less than a decade, whereas the Human Genome project took 15 years 2. This begs to question the government’s spending and healthcare reforms. Is there not a way to pass the tremendous amounts of savings to end users of healthcare by approaching healthcare research in an improved manner? Stem cell research has been another field of interest that shows immense promise in treating incurable diseases and repairing damaged organs in patients without transplantation techniques. The government has been going back and forth when it comes to supporting stem cell research with the changes in administration. However, stem cell treatment and research still have a long way to go before many of the risks and unknowns associated with it can be appropriately addressed.
The advancement made in fields such as artificial intelligence, blockchain implementation and stem cell therapy including a plethora of other advancements can significantly reduce the cost while increasing the efficiency of the healthcare service. These costs can be saved and passed to the patients and healthcare users to ensure that they can access the services they need without a burden. However, the government is very far behind when it comes to the technological advancements that are rapidly taking place.
The specific CPT ruling by the American Medical Association states that for intraosseous infusion, only the 36680 CPT code can be used and the codes 963xx are not to be used. The 963xx codes apply to intravenous and intramuscular injections. According to the injection and infusion criteria in the CMS National Correct Coding Initiative (NCCI) Policy Manual, “CPT codes 96372-96379 are not intended to be reported by the physician in the facility setting” and “only the E/M service will be reimbursed, and the therapeutic and diagnostic Injection(s) are not separately reimbursed, regardless of whether a modifier is reported with the Injection(s)”3. When intraosseous infusions are considered, often in instances of critically ill or injured patients, medication administration charge is not allowed by Medicare. Intraosseous infusion is complicated when compared to intravenous and intramuscular injections in that they are used to inject directly into the bone marrow, whereas the intravenous injections administer the medication into a vein or the bloodstream and intramuscular injections deliver the drug into the muscle. These commonly used intravenous and intramuscular injections are not subject to reimbursement which shows how far behind the government is in health insurances and payments.
When considering the tremendous amount of money that is spent in ways not directly helping patient care, such as in the case of the human genome project, an essential and rarely addressed question comes up. Should the government and the people rethink the policies and expenditure priorities to offer an affordable and efficient service to the general public to lower medical bills?
- Human Genome Information Archive. “About the Human Genome Project”.S. Department of Energy & Human Genome Project program. Retrieved 1 August 2013.
- Shampo, M. A., & Kyle, R. A. (2011). Craig Venter—The Human Genome Project. Mayo Clinic Proceedings, 86(4), e26–e27. http://doi.org/10.4065/mcp.2011.0160
- com. (2018). INJECTION AND INFUSION SERVICES POLICY, UnitedHealthcare Oxford Reimbursement Policy. [online] Available at: https://www.oxhp.com/secure/policy/injection_and_infusion_services_policy.pdf [Accessed 2 Feb. 2018].