MARY AGNES CAREY: Right. That is definitely the balance that’s in the works. If you ask beneficiaries to contribute more, what do you ask the providers to do? For example, some ideas that are out there, they’ve been around for a while: Do you look at the fee-for-service Medicare structure on co-payments and deductibles? Combine those into one deductible, for example, but add a catastrophic cap, which doesn’t exist in fee-for-service Medicare. On providers: As we know, their payments will continue to increase over the next ten years, but under the health care law they’re going to do so at a slower rate. So do you go back to providers, to hospitals, to the nursing homes, to home health care agencies, and take more from them? And how do you balance that pain to get an equal result?
Video: Medicare Supplement Providers
MFT Progress Notes: Two reasons why Medicare needs family therapists
Happy Now? Obama Cuts Medicare…Again
The new cuts come in the form of a planned reduction in the reimbursement rates the government pays to insurance companies that operate Medicare Advantage plans, which are services administered by private for-profit or non-profit providers that offer additional services than can be found in traditional Medicare.
Bundled payments, DMEPOS, regulatory reform, and ESRD
We also announced a major expansion of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. In its first year of operation, competitive bidding, where prices are based on suppliers’ bids, saved the Medicare program, and taxpayers, over $202 million, while maintaining access to quality products for Medicare beneficiaries in the nine areas of the country where the program launched. It’s a great example of the Administration’s determination to put the brakes on runaway healthcare costs. With this expansion in the program, Medicare beneficiaries in 91 major metropolitan areas will save an average of 45 percent on certain DMEPOS items beginning in July. Between 2013 and 2022, we estimate that the expansion of the DMEPOS program will save Medicare $25.7 billion, while saving beneficiaries, who pay a percentage for medical equipment and supplies, $17.1 billion through lower prices.
New AMIC Survey Data Shows 2010 Medicare Payment Cuts Forcing Physician Practices and Imaging Providers to Reduce Patient
In the past, the Obama Administration has proposed using RBMs in the Medicare program. However, the Department of Health and Human Services (HHS) previously weighed in on prior authorization in the Medicare program, noting in 2008 that a prior authorization program could be “inconsistent with the public nature of the Medicare program,” since such programs rely on private companies using proprietary systems to deny care prescribed by a physician. HHS also noted that the Medicare appeals process guaranteed to every beneficiary could overturn a “high proportion” of denials, rendering the policy ineffective. In an environment of reduced reimbursements, the AMIC survey further demonstrates that application of RBMs is an ineffective model imposing unnecessary administrative costs on practices, thereby creating artificial barriers for patients in need of care.
Uwe E. Reinhardt: What Hospitals Charge the Uninsured
After some deliberation, the commission recommended initially that the New Jersey government limit the maximum prices that hospitals can charge an uninsured state resident to what private insurers pay for the services in question. But because the price of any given service paid hospitals or doctors by a private insurer in New Jersey can vary by a factor of three or more across the state (see Chapter 6 of the commission’s final report), the commission eventually recommended as a more practical approach to peg the maximum allowable prices charged uninsured state residents to what Medicare pays (see Chapter 11 of the report).
Protect yourself against Medicare/Medicaid fraud — Business — Bangor Daily News — BDN Maine
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Make voice heard on Medicare
If you have Medicare coverage, you may receive the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey in the coming weeks, giving you an opportunity to rate your satisfaction with your Medicare health insurance and doctors. The Centers for Medicare & Medicaid Services (CMS) conducts this annual survey to hear directly from select beneficiaries about the quality of Medicare health plans and care providers.
Medicare Reform Proposal Could Save Providers $676 Million Annually
“We are committed to cutting the red tape for healthcare facilities, including rural providers,” said Health and Human Services Secretary Kathleen Sebelius. “By eliminating outdated or overly burdensome requirements, hospitals and healthcare professionals can focus on treating patients.” The proposed rule is designed to help healthcare providers operate more efficiently by eliminating regulations that are out of date or no longer needed. Many of the rule’s provisions streamline the standards healthcare providers must meet in order to participate in the Medicare and Medicaid programs without jeopardizing beneficiary safety. For example, a key provision reduces the burden on very small critical access hospitals, as well as rural health clinics and federally qualified health centers, by eliminating the requirement that a physician be held to an excessively prescriptive schedule for being onsite once every two weeks. This provision seeks to address the geographic barriers and remoteness of many rural facilities, and recognize telemedicine improvements and expansions that allow physicians to provide many types of care at lower costs, while maintaining high-quality care. Among other provisions, the proposed rule would:
Safety Net Scene: March Provider Bulletin and the new “ACA Implementation News
Click here to read the March Provider Bulletin. The index includes: All Providers…………………………………..1 Medicare-Medicaid Enrollees……………..1 Medicare/Medicaid Crossover Claims….1 Record Retention……………………………..1 Planning for ICD-10…………………………..2 Second Phase NCCI…………………………2 …and more. Also, the Colorado Department of Health Care Policy and Financing has a new publication called “ACA Implementation News.” It is meant to “keep county partners, Medical Assistance (MA) sites and other stakeholders informed about Department of Health Care Policy and Financing (Department) activities and opportunities to participate in the implementation of the eligibility provisions of the Affordable Care Act (ACA).” Click here to read the February 2013 issue. [Source: Colorado Department of Health Care Policy and Financing]
Sequestration Reduced Your Medicare Pay? You Have Four Options
What’s more, increasing patient volume will inevitably draw down on provider and staff morale, and increase stress. Patient experience and patient satisfaction suffers. The inevitable reduction in Pay-for-Performance (P4P) incentive payments by commercial health plans to doctor in private practice, and the P4P value-based incentive payments to hospital value-based purchasing programs based on reduced HCAHPS scores would also negatively impact the bottom line.
Medicare Premium Dollars Spent
Last night as I was thinking about sleeping, an odd thought hit my brain. The oddity had me rethink the current Medicare situation and the dwindling dollars available for providers. CMS has truly analyzed the situation in the worst way possible. You know how charities report how much of your dollars given go toward actually helping whoever you are desiring to help? What if? What if CMS had to report how Medicare premium dollars were spent?