Health law, elections trigger questions about Medicare payment issues

Kaiser Health News / The Washington Post: "While most people are focused on the midterm elections Tuesday, the American Medical Association is gearing up for the lame-duck congressional session scheduled to start Nov. 15. Unless Congress intervenes, payments to doctors for treating Medicare patients will be cut by 23 percent on Dec. 1 and another 6.5 percent on Jan. 1. Cecil B. Wilson, an internist from Winter Park, Fla., who became AMA president in June, is pressing for a 13-month patch that would prevent the Medicare physician cuts. In April, the Congressional Budget Office said that blocking the cuts until January 2012 would cost about $15 billion. A long-term formula fix, through 2020, would cost about $276 billion, it said." KHN interviewed Wilson about the AMA's strategy for fixing Medicare payments (Villegas and Carey, 11/1).

Meanwhile, American Medical News reports on efforts to improve payment models for the federal programs: "A new federal agency is poised to start exploring ways to reform Medicare and Medicaid's payment and delivery systems. Leaders at the Center for Medicare and Medicaid Innovation will root out unnecessary services and treatments that result in preventable complications for patients. They also plan to develop more effective therapies that target chronic diseases, medical errors and safety concerns. They are finalizing their goals as the agency nears its January 2011 startup date. CMMI comes from the health system reform law adopted earlier this year, which directed the Dept. of Health and Human Services to develop a working framework for how existing and new programs can reduce Medicare and Medicaid costs, while preserving or enhancing patient care. … The center has $5 million in fiscal year 2010 to help it get up and running. It has a $10 billion budget between 2011 and 2019 to test models that could improve Medicare and Medicaid" (Silva, 11/1).

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.