All Articles In 'Medicare Reform'
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 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 [...]
Chronic Care Management: CMS Multiple Chronic Conditions Dashboard
Many new care models in both the public and private sector focus on people with chronic diseases, particularly conditions like diabetes, congestive heart failure, and hypertension. The Veterans Health Administration (VHA) Care Coordination/Home Telehealth (CCHT) pilot program [...]
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, [...]
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 [...]
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