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Medicare advisory panel urges co-pay for home health visits

The Medicare Payment Advisory Panel recommended this policy as a means to discourage overuse of home health services, which are estimated to cost taxpayers nearly $20 billion a year and are also a source of health care fraud. Meanwhile, another story, this one from WBUR, offers tips for Medicare "wellness" visits.

14 Jan 2011

First Edition: January 11, 2011

Today's headlines include reports about how a recent high court ruling may offer clues as to how the Supreme Court will view a key aspect of the health overhaul law.

11 Jan 2011

Some in health industry raising concerns about Accountable Care Organizations

CQ HealthBeat: "The medical device industry told the Centers for Medicare and Medicaid Services that it's concerned about whether accountable care organizations could give providers financial incentives to hold back on needed patient care, particularly on technology. Meanwhile, insurance plan executives warned CMS officials that the ACOs could give hospitals and doctors new bargaining leverage in negotiations with insurers.

8 Dec 2010

Minnesota pilot project seeks to save Medicare money by addressing readmission rates; MedPac offers draft payment recommendations

Last February, Fairview Southdale Hospital in Edina set out to try to reduce readmissions for Medicare patients as part of a pilot project with UCare, a small Minnesota health plan. The result: The 30-day readmission rate dropped by 44 percent. ... It's one way, experts say, that Medicare hopes to save billions of dollars (Lerner, 12/2).

4 Dec 2010

Congress must stop Medicare cuts in November

The AMA, along with medical societies representing 50 states and the District of Columbia and 65 national physician organizations, united to send a strong message to Congress – immediate action is needed to stop the drastic 30 percent Medicare payment cuts looming at the end of this year to protect seniors’ access to health care.

29 Sep 2010

White House predicts overhaul will save $8 billion for Medicare by the end of 2011

The White House says the new health law will save Medicare about $8 billion by the end of next year and $575 billion during the rest of the decade, according to a new report the Obama administration is releasing Monday, The Associated Press reports.

3 Aug 2010

First Edition: July 2, 2010

Today's health policy headlines include the latest developments regarding Virginia's legal challenge to the federal health care overhaul.

2 Jul 2010

Congressional hearing explores Medicare payment issues, including permanent 'doc fix'

A House Energy and Commerce Committee hearing Wednesday ostensibly about a recent Medicare Payment Advisory Commission report veered to discussion of the so-called "doc fix." The panel's chairman, Rep. Frank Pallone, D-N.J., called the ongoing efforts to delay the 21 percent cut in Medicare physician payments "the elephant in the room" and added that the "Democrats and Republicans in the House and Senate, as well as the physician community, need to work together to develop a permanent fix to this problem that has vexed all of us for far too long.

25 Jun 2010

AAIM identifies core principles that delineate shortfalls of GME funding

The Alliance for Academic Internal Medicine has identified core principles that delineate the shortfalls of graduate medical education funding. In light of the current state of Medicare GME financing and the Medicare Payment Advisory Commission's June 2010 report, AAIM encourages GME reform to address these shortfalls in light of societal health care needs.

18 Jun 2010

ASTRO urges MedPAC to recommend end to abuse of physician self-referral law in radiation oncology

The American Society for Radiation Oncology (ASTRO) commends the Medicare Payment Advisory Commission (MedPAC) for highlighting concerns about physician self-referral in cancer care in its report released yesterday. We urge the commission to make recommendations to Congress to end abuses of the physician self-referral law in radiation oncology enabled by the "in-office ancillary services exception."

17 Jun 2010

PAF annual report offers summary of issues impacting Americans' access to healthcare

Patient Advocate Foundation -- a national non-profit organization that seeks to safeguard patients through effective mediation assuring access to care, maintenance of employment and preservation of their financial stability relative to their diagnosis of life threatening or debilitating diseases -- today released their annual Patient Data Analysis Report, which documents the scope and complexity of the healthcare finance, access and job retention issues routinely confronted by patients at the national and state-specific level.

29 Apr 2010

Companies providing home care receive large Medicare reimbursements

An analysis of Medicare payments to home health care companies by The Wall Street Journal indicates that some might be taking advantage of the system. According to the analysis, the industry's largest company, Amedisys Inc., "provided many of its patients just enough therapy visits to trigger the extra $2,200 payment.

28 Apr 2010

Orszag says new Medicare payment board will help lower deficit

"An Independent Payment Advisory Board (IPAB) established under the healthcare reform act will help to ensure the nation's future fiscal health, Office of Management and Budget Director Peter Orszag said Thursday," McKnight's Long Term Care News & Assisted Living reports. "If set up correctly, the Medicare payment board will contribute to a reduction in national health costs and the federal deficit, Orszag said before the Economic Club of Washington last week, according to the Bureau of National Affairs.

12 Apr 2010

Utilization rates of noninvasive diagnostic imaging procedures for Medicare population vary regionally

The utilization rates of noninvasive diagnostic imaging procedures such as computed tomography scans, magnetic resonance imaging, and positron emission tomography for the Medicare population vary substantially from region to region, with Atlanta, GA, having the highest utilization rate and Seattle, WA, having the lowest, according to a study in the April issue of the American Journal of Roentgenology.

23 Mar 2010

Research roundup: Insurance crisis tough on middle class; Hospitals' profit margins on private patients up

Private-Payer Profits Can Induce Negative Medicare Margins - "Hospitals' profit margins on privately insured patients have risen dramatically in recent years, while profit margins on Medicare patients have fallen," write the authors, who all work for MedPAC.

20 Mar 2010

Cut looms for Medicare payments to doctors

Marketwatch/The Seattle Times reports on the looming 21 percent cut to physicians' Medicare payments. "The cut was to take effect March 1 until Congress delayed it by 30 days. The Senate then voted last Wednesday to postpone the cut an additional six months as part of a larger bill that extends unemployment benefits. The measure now moves to the House."

17 Mar 2010

Medicare payment issues raise questions, concerns

Medicare payment issues including rising costs, caps on physical therapy and other outpatient services for some patients are in the news.

8 Mar 2010

MedPac urges Feds to cut payments to private insurers

Reuters: The Medicare Payment Advisory Commission (MedPac) on Monday issued nonbinding recommendations that Medicare "cut U.S. government payments to private insurers and home healthcare providers." The panel, which is an independent body set up to advise Congress on Medicare, "repeated its earlier call for the federal government to pay private insurers that offer coverage known as Medicare Advantage the same as it pays when Medicare reimburses providers directly."

2 Mar 2010

Senate fails to repeal Medicare physician payment formula

A Medicare meltdown now seems certain, as the U.S. Senate has left early for the weekend, abandoning seniors, military families and baby boomers. The Senate failed to repeal the Medicare physician payment formula that will cause a drastic 21 percent payment cut to physicians who care for Medicare and TRICARE patients.

28 Feb 2010

With rate cut looming, doctors threaten to stop accepting Medicare patients

With a 21 percent Medicare reimbursement rate cut set for Monday, unless Congress acts to block it, some doctors are threatening to refuse new Medicare patients in their practices.

26 Feb 2010