Medicare payments can vary from hospital to hospital for many reasons, including the type of hospital, regional wages and salaries, the income mix and sickness of patients and the level of intensity with which patients are treated. Some hospitals may order more tests, have patients see more doctors or make higher use of intensive-care beds. Costs could also rise if subpar care extends a hospital stay or forces additional tests.
Video: What Does Medicare Cost?
Medicare Physician Payment: The RUC’s Hollow Victory
Judge Nickerson acknowledged the physicians’ core argument in the opening summary of the case facts: As CMS’ sole advisor on medical services valuation for two decades, the RUC is a “de facto” federal advisory committee that should fall under the public interest rules of the Federal Advisory Committee Act (FACA). The physicians argued that this flawed process has resulted in an over-valuing of specialty care, an undervaluing of primary care and a distortion of health care markets, utilization and cost. But the ruling ignored their argument, explicitly avoiding any evaluation or discussion of the requirement that federal advisory bodies adhere to FACA.
Medicare Spotlights Hospitals With Especially Costly Patients
The Medicare data indicated big spending differences in areas of the country that have not generally been thought of as high users of Medicare services. In Kansas City, Mo., the average patient admitted to St. Joseph Medical Center cost Medicare $19,247 during a stay and in the month afterward, 7 percent above the national median. Fifteen miles away, according to the data, an essentially similar patient admitted to Truman Medical Center-Lakewood cost Medicare $15,290, or 15 percent below the national median. The owner of St. Joseph, Corondelet Health, which is part of the nation’s largest Catholic nonprofit system, Ascension Health, declined to comment. Truman said in a written statement: “It is important that there be a comprehensive analysis of this data and its variables before final reimbursement conclusions are reached.”
Study: Calif. Hospital Patients Costly to Medicare Program
Five out of the top 10 hospitals where patients cost Medicare the most money are located in California, according to a Kaiser Health News analysis of data published on the CMS Hospital Compare website. The five hospitals are:
How Much Do The Nation’s Pre
The Health Services Cost Review Commission (“HSCRC” or “commission”) was established by the General Assembly in 1971. The Commission’s mandate includes reviewing and approving rates that Maryland hospitals can charge for their services and making Maryland hospitals’ financial information available to the public. The HSCRC sets rates for all payers including private insurance companies, HMOs, MCOs, Medicare and Medicaid. This system is referred to as the “all-payer” system, in which all payers pay their fair share of hospital costs. In establishing the HSCRC, the Maryland General Assembly set out to accomplish the following objectives: • keep hospital services affordable; • expand access to hospital care for those without insurance; and • provide accountability for hospital performance to the public and state government As part of its rate-setting activities, the HSCRC collects data from hospitals, which are used to monitor hospital utilization and charges, as well as to set inpatient rates. These data are used to generate the statistics reported in this guide..
Why some hospitals cost Medicare more than others
The Centers for Medicare & Medicaid Services revealed wide variations in cost efficiencies among hospitals, some just a few miles apart from each other. For example, Los Angeles Community Hospital’s average patient costs Medicare $24,644 during the stay and in the following month, 37 percent above the national median ($17,988). A similar patient, however, admitted to Ronald Reagan UCLA Medical Center across town costs Medicare $17,628–2 percent below the median, Kaiser Health News reported. Since the agency quietly added the cost-per-Medicare-beneficiary scores of acute care hospitals to Hospital Compare last week, the data showed that patients treated at hospitals in Las Vegas, Fort Lauderdale, Newark, Miami, Los Angeles and Orange County, Calif., had treatment costs higher than the median, according to the Kaiser Health News analysis. On the flip side, patients treated at hospitals in Anchorage, Des Moines, Honolulu, Minneapolis and Portland, Ore., tended to cost Medicare less.
Iowa ranks high for low hospital costs
According to the study, the national median was $17,988 for a hospital visit for a Medicare patient, as measured from May 2010 to February 2011. In Iowa, the median average was $16,427, with the lowest costs at Broadlawns Medical Center in Des Moines, Keokuk Area Hospital in Keokuk and Mercy Hospital in Iowa City. All three of those came in with a median average of $15,110. The study is based on federal Medicare data and was conducted by Kaiser Health News.
Medicare and Medicaid Reforms That Can Help Curb Costs @PolicyMic
Innovation has resulted in major advances in clinical abilities, the development of new procedures and treatments (including treatments for previously untreated terminal conditions), and improvements in the scope of medicine covered through the health care system. Through effective health technology assessments, it becomes possible to explore strategies to control rising costs without stifling technological innovation. Health technology assessment, the process by which health care systems conduct cost-benefit analysis for new technology, is particularly important in determining the spread of innovation. Assessments should be carried out in conjunction with comparative effectiveness research (CER), which is “designed to inform health care decisions by providing evidence on the effectiveness, benefits and harms of different treatment options.”5 The $1 billion in funding for CER through the American Recovery and Reinvestment Act, as well as the support for CER through the 2010 Affordable Care Act, present critical steps toward establishing the end goal of patient-centered outcomes research. While this research will determine the clinical effectiveness of medical treatments, new technology must also be assessed for cost-effectiveness and cost-benefits analysis when compared with existing technology.
“Right Wing Social Engineering”: What Romney’s Medicare Plan Actually Does
DC journos have spent much of the 2012 election trying to answer the question of how exactly a President Romney would govern. On one side, there are the skeptics who never bought into Romney’s rhetoric during the Republican nomination. They argue Romney is, at heart, still a moderate northeastern governor, a businessman unsuited for the extremism that has come to dominate his party. Others are equally convinced that Romney must be taken at face value. Sure he might have positioned himself in the middle while he governed a state dominated by Democrats, but he has spent the past five years running for president full-time, aligning himself with every right-wing whim over the course of his two campaigns. He’s the Republican who sought the endorsement of Ted Nugent, discarded a gay spokesman, and calls corporations people. Lest we forget, it was Romney who was poised to run as the right-wing challenger to John McCain and Rudy Giuliani in 2008 before Mike Huckabee swooped in to steal the evangelical vote.
Report Shows Lower Costs in Medicare Due to the Affordable Care Act
Washington, DC—(ENEWSPF)—April 23, 2012. The Medicare Program will save over $200 billion through 2016 due to the Affordable Care Act, and beneficiaries in traditional Medicare will enjoy $59.4 billion in lower costs, according to a report released today by the Centers for Medicare & Medicaid Services (CMS). According to estimates from the CMS Office of the Actuary, the over $200 billion in short-term savings to the Medicare program come from ending excessive payments to private insurers who offer Medicare Advantage plans, implementing anti-fraud measures, and changing provider payment policies to reflect improvements in productivity. In addition, according to the HHS Assistant Secretary for Planning and Evaluation, seniors and people with disabilities in traditional Medicare will see lower cost-sharing and premiums as a result of the Affordable Care Act, totaling $59.4 billion through 2016 and $208 billion through 2021.