All Articles In 'Medicare Budget'
Medicare Special Needs Plans: MedPAC Recommendations on Future of Special Needs Plans
Special Needs Plans (SNP) are part of the Medicare Advantage program and were created by the Medicare Modernization Act of 2003 (MMA). There are three types of SNPs, each intended to provide coordinated care for Medicare [...]
Medicare Hospital Payment: MedPAC Recommends One Percent Rate Increase for FY 2014
Hospitals face another year of tight Medicare reimbursement, with rates for FY 2014 falling farther behind cost increases and margins declining as a result. Most hospitals already lose money on caring for Medicare and Medicaid patients. [...]
Medicare and Medicaid Spending on Dual Eligible Populations: Analysis of Health Costs
Much of the story about rising health costs and spending has to do with relatively small groups of people with expensive health needs. For example, the Centers for Medicare and Medicaid Services (CMS) estimates Medicare beneficiaries [...]
Medicare Physician Sustainable Growth Rate: Repealing SGR
For over a decade, the sustainable growth rate (SGR) has been a source of financial worry for physicians who serve Medicare patients. Medicare’s physician payment rate is based on a composite measure of the cost of [...]
Medicare Payment Reform: Post-Acute Provider Reimbursement
The term “post-acute care” (PAC) covers a range of services patients receive after a hospital stay. Skilled nursing facilities, home health care agencies, long-term care hospitals, and inpatient rehabilitation hospitals all provide post-acute care. PAC providers [...]
Medicaid Expansion and Hospitals: Hospital Medicaid Revenue to Outpace Crowd-Out Losses
The Affordable Care Act (ACA) created a trade-off for providers, particularly hospitals: On the one hand, Medicare fee-for-service hospital payments will be cut by $260 billion over 10 years. Some people newly eligible for Medicaid will [...]
Medicare-Medicaid Dual Eligibles: Measuring Quality of Special Needs Plans and State Demonstrations
Medicare-Medicaid dual eligibles are often held up as a prime case for the need for better care management to reduce health costs and spending while improving quality. But doing so can be challenging. Most dual eligibles [...]
Payment Reform Models: Employers Explore Population-Based and Bundled Payment
For the past several years, major payers in U.S. health care have experimented with new payment models that create incentives to control unnecessary health care spending. The traditional fee-for-service model for health insurance does not give [...]
5 Causes of Wasteful Health Care Spending
A painful fact about the U.S. health system is that roughly one third of health costs and spending are wasted. A study in the Journal of the American Medical Association (JAMA) found that wasted health spending [...]
The Promise of Telehealth: Three Case Studies of Early Adopters
Much of the health information technology (HIT) today promotes patient communication to improve care and potentially lower costs. Some examples are interactive preventive health records (IPHR), e-prescribing, and electronic health records (EHR). Emerging telehealth technologies, however, [...]
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