The Rationalization of Medicare?

[amborin]

Medicare Plan for Payments Irks Hospitals

Medicare Plan for Payments Irks Hospitals

WASHINGTON — For the first time in its history, Medicare will soon track spending on millions of individual beneficiaries, reward hospitals that hold down costs and penalize those whose patients prove most expensive.

The administration plans to establish “Medicare spending per beneficiary” as a new measure of hospital performance, just like the mortality rate for heart attack patients and the infection rate for surgery patients.
Hospitals could be held accountable not only for the cost of the care they provide, but also for the cost of services performed by doctors and other health care providers in the 90 days after a Medicare patient leaves the hospital.

This plan has drawn fire from hospitals, which say they have little control over services provided after a patient’s discharge — and, in many cases, do not even know about them. More generally, they are apprehensive about Medicare’s plans to reward and penalize hospitals based on untested measures of efficiency that include spending per beneficiary.

A major goal of the new health care law, often overlooked, is to improve “the quality and efficiency of health care” by linking payments to the performance of health care providers. The new Medicare initiative, known as value-based purchasing, will redistribute money among more than 3,100 hospitals.


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The new health care law directs the secretary of health and human services to develop “efficiency measures, including measures of Medicare spending per beneficiary.” Obama administration officials will decide how to calculate spending per beneficiary and how to use it in paying hospitals.

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http://www.nytimes.com/2011/05/31/health/policy/31hospital.html?_r=1&scp=2&sq=medicare%20and%20hospitals&st=cse


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Health Care Reform: Physicians’ Perspective

Financing - Total Cost ~ $950B/10 yr -

Nearly half from cuts to Medicare program •

About $136 Billion from Medicare Advantage -

About half from taxes on individuals, employers, and industry "fees" •

Non-deductible annual insurer fee •

40% "Cadillac plan" tax  SGR still not addressed! -

Estimated costs ~ $228 Billion/10 yr

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http://merage.uci.edu/ResearchAndCenters/HealthCare/Resources/Documents/Cohen%20052710.pdf