All Articles In 'Medicare Payment'
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. [...]
Health Care Costs: Slowdown in Growth is Because of Economy, Not Obamacare
Growth in health care spending has slowed recently. Why? Supporters of the Affordable Care Act (ACA) – aka Obamacare – says its due to the controversial law, although most of the ACA’s provisions are yet to [...]
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 [...]
Dual Eligibles and Medicare Cost Sharing: State Medicaid Payment of Medicare Premiums, Deductibles, and Co-Payments
State Medicaid programs will spend about $175 billion this year on health care for dual eligibles – low-income seniors and persons with disabilities who receive benefits from both Medicare and Medicaid. State spending on dual eligibles [...]
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 [...]
Physician Payment Reform: Preparing for Value-Based Reimbursement
Primary care is shifting to payment based on providing higher quality, lower cost health care. New payment models – such as patient-centered medical homes (PCMH) – replace or supplement traditional fee-for-service payments with per-member per-month payments, [...]
Payment Reform Models: Coordinated Primary Care for Employees
Coordinated primary care models have shown great potential to reduce health care costs while improving care, a goal that will become even more important after the Affordable Care Act (ACA) coverage expansion provisions take full effect [...]
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