Essays on Employee Health Benefits and Other Health Care Topics, Hosted by Brian Klepper
Paul Levy
Posted 12/22/11 on Not Running A Hospital
John McDonough, one of the health care experts in Massachusetts, writes on his blog about the three-year renewal of the state’s Medicaid waiver. John presents a history of the waiver and notes that it provides the “green glue,” i.e., the infusion of federal cash, that makes possible the health care reform process approved by this state several years ago.
Merrill Goozner
Published 11/25/11 in the Fiscal Times
Holiday cheer and bipartisan bonhomie are still possible on Capitol Hill.
For evidence, one need only look at the so-called “doc fix,” where Congress every year overrides a previous effort at health care cost control to ensure physicians get paid at least as much as they did the year before. Expect another present to arrive at physicians’ offices sometime between Thanksgiving and Christmas, now that the Super Committee has failed to permanently resolve the issue as part of Medicare’s contribution to long-term deficit control.
Jeff Goldsmith
Posted 11/16/11 on The Health Affairs Blog
Copyright ©2011 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.
The Medicare Payment Advisory Commission (MedPAC) is the closest thing Congress has to adult supervision on important health policy questions. The Commission commands bipartisan respect both for its record of sound policy advice and for its leadership.
With its October recommendations, MedPac attempted to solve the sustainable growth rate (SGR) physician payment formula budget crisis by spreading its more than $300 billion cost beyond the physician community. More than two-thirds of the burden would fall on hospitals, pharmaceutical and device manufacturers and, significantly, on Medicare beneficiaries themselves. Clearly MedPac’s intent was to widen the circle of pain.
Continue reading “MedPAC’s SGR Solution: Bad Medicine For A Chronic Problem”
David Harlow
Posted 11/7/11 on Health Blawg
CMS issued the final MPFS — the Medicare Physician Fee Schedule for 2012 — this past week. The key feature of the rule, for many folks, is the Sustainable Growth Rate-(SGR)-mandated 27.4% cut in Medicare professional serivces reimbursements. We now get to watch the drama unfold over the next eight weeks, as the MedPAC proposal to replace the SGR is bandied about, and the machinations of the supercommittee tasked with brokering a budget fix either do or do not get us closer to a reasoned approach to doing more with less. The MedPAC idea is to drop the RBRVS conversion factor for specialty care payments 5.9% per year for two years, then hold it steady for 8 years, while keeping the primary care conversion factor flat for 10 years. The net effect: physician payments will “only” double over the next 10 years. (One clever idea squirreled away in the MedPAC report is that savings in the Medicare Shared Savings Plan (ACO) should be measured against a baseline of what Medicare would have spent on the care absent the changes in the proposed SGR fix — i.e., a higher baseline, with greater potential savings. Another 50 clever ideas like this and we’ll be talking about saving some real money.)
Continue reading “The 2012 Medicare Physician Fee Schedule is Finalized”
Merrill Goozner
First published 5/06/11 in The Fiscal Times
The annual scramble to prevent next year’s scheduled pay cut for doctors who treat Medicare patients kicked off Thursday with physician leaders calling for a five-year program of guaranteed annual raises and a high-ranking Republican calling for another short-term fix.
The issue – known inside the Beltway as “the doc fix” – is the residue of a law enacted by Congress in the late 1990s that sought to limit the growth of Medicare spending. The law limited physician pay increases to same growth as the overall economy, which became known as the sustainable growth rate or SGR. Since health care spending over the last decade grew twice as fast as gross domestic product, implementing the SGR would dramatically shrink physician pay as a share of overall Medicare spending.
Continue reading “What Cost Controls? Republicans To Seek Multi-Year Doc Fix”
Care And Cost 