All Articles In 'Medicare Spending'

Medicare Special Needs Plans: MedPAC Recommendations on Future of Special Needs Plans

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

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

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

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

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

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

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 [...]

Payment Reform Models: Employers Explore Population-Based and Bundled Payment

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

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 [...]

Basics of the Federal Budget Process

Basics of the Federal Budget Process

The federal budget has been in the news more than usual lately. Congress early in 2013 postponed a 2 percent across-the-board cut in Medicare payments, 8 percent cuts for certain domestic spending, and 10 percent cuts [...]