MedPAC Takes Aim at Outpatient Billing Trend

As Congress tries to reform Medicare, the program's independent advisor has its own suggestions, including a call to end to what has become a revenue buffer for many hospitals and an integral part of their physician acquisition strategies.
Published Online: March 20, 2014
As Congress tries to reform Medicare, the program's independent advisor has its own suggestions, including a call to end to what has become a revenue buffer for many hospitals and an integral part of their physician acquisition strategies.

In its 15th March report, the first of two published each year, the Medicare Payment Advisory Commission warns of a looming crisis for the nation, noting that the Medicare Trust Fund is slated to run dry by 2026 and arguing that “significant variation” in quality and spending is “putting beneficiaries at risk” both “medically and financially.”

The Commission, also known as MedPAC, is building on previous years’ proposals and calling for an equalizing of payments for similar services across the settings, as a way to replace what the 17 members describe in the report as an unorganized reimbursement system riddled with poor incentives.

Read the full story here: http://bit.ly/1g5lqoA

Source: Healthcare Payer News



Feature
Recommended Articles
Physicians at the Brigham and Women’s Hospital have published results from a proof-of-concept study that used mass spectrometry in almost real-time to detect and delineate pituitary tumors from normal tissue.
All-cause mortality and hospitalization rates and inpatient expenditures among Medicare fee-for-service beneficiaries decreased from 1999 to 2013.
Legislative action on Medicare’s Sustainable Growth Rate (SGR) could have important implications for physicians, especially in terms of financial risk. In the 13th part of the Healthcare Reform Stakeholder Summit, panelists Francois de Brantes, MS, MBA, Ateev Mehrotra, MD, MPH, and Arthur Vercillo, MD, FACS, delved into the topic of SGR reform.
Officials say the number of enrollees and their relative good health made it possible to negotiate lower rate increases. However, premium increases are higher in Northern California, where there is less competition.
Commercial health plans will soon face a new Federal rule that will require them to provide counseling to obese and some overweight beneficiaries—and most will need help complying. Omada Health co-founder and CEO Sean Duffy, writing this month in Evidence-Based Diabetes Management, tells how the CDC has opened the door for digital health programs to offer a scalable, effective solution.