Medicare

The House Ways and Means Committee's Health panel takes a fresh look Tuesday at replacing Medicare's payment system for doctors.

Combining Medicare coverage under a unified benefit could save $180 billion over 10 years while lowering out-of-pocket costs for beneficiaries, according to a new study.

Researchers with the Commonwealth Fund, a non-profit research foundation, proposed a simplified Medicare program in which beneficiaries receive hospital, physician, drug and supplemental coverage in a single package.

"Medicare Essential" would lower costs and create rewards for beneficiaries who choose efficient and high-quality medical providers, researchers said. 

Three frequently cited avenues for curbing cost growth in Medicare would also lower enrollment in the program, leaving seniors vulnerable as they face health problems, according to a new study.

The RAND Corporation measured the budget and enrollment consequences of imposing a premium on Medicare's hospital insurance, introducing vouchers, and raising the program's eligibility age to 67.

Each policy would trim Medicare rolls by about 2 to 14 percent, the study found. Authors urged lawmakers to consider the full "costs and benefits" of each path for beneficiaries.  

Read more...

Reforming Medicare’s sustainable growth rate (SGR) formula will be back on the agenda this week as members of the House tax-writing panel hear from healthcare stakeholders.

The Ways and Means subcommittee on Health will hold a hearing Tuesday to field input on SGR repeal from doctors, surgeons, cardiologists and policy experts.

Both the Ways and Means and Energy and Commerce panels have called SGR repeal a major priority for the current legislative season. 

A bevy of healthcare experts released recommendations Monday for cost-conscious reforms to Medicare, Medicaid and private insurance they said could save $1 trillion over two decades.

In a Brookings Institution study, the experts urge Washington to embrace small, consensus-driven policy moves to lower healthcare costs rather than wait for a major deficit-reduction deal.

"The time to act on these proposals is now," study authors wrote. "It is time to put a sharp and direct focus on achieving both better health and cost savings." 

The Obama administration wants to increase the amount it pays hospitals under Medicare.

In a 1,424-page proposal, set to be published in the Federal Register on May 10, the Center for Medicare and Medicaid Services (CMS) is proposing to increase the operating rates for long-term and short-term acute care at inpatient hospitals that treat patients covered by the government healthcare program, and is laying out some new features of the Affordable Care Act.

The CMS proposes increasing payments for acute care, which include short stays for non-chronic conditions like severe injuries or brief illnesses, by 0.8 percent, or about $27 million.

The agency also wants to increase payment rates for long-term care by 1.1 percent in 2014, estimated to come out to $62 million.

The agency's proposed increases account for offsets and reductions in spending, and would take effect starting in October.

Cancer clinics say the cuts they are facing are far more serious — and should have been a higher priority.

The Obama administration is proposing to increase the maximum reward for reporting Medicare fraud to $9.9 million, saying that it could provide an incentive to whistleblowers.

Since 2010, the Centers for Medicare & Medicaid Services (CMS) has recouped more than $14.9 million in fraudulent Medicare funds. The new proposal, the agency says, will root out a net $24.5 million in additional recovered revenue each year.

“President Obama has made the elimination of fraud, waste and abuse, particularly in healthcare, a top priority for the administration,” said Health and Human Services Secretary Kathleen Sebelius in a statement on Wednesday.

A solidly bipartisan group of more than 100 lawmakers is urging the Obama administration to reverse Medicare cuts to cancer clinics.

The lawmakers questioned whether the Medicare agency can change the way the automatic cuts have been applied, so that cancer clinics won't be hit as severely.

While Republicans and Democrats have traded blame for the automatic budget cuts known as "sequestration," the latest inquiry to the Medicare agency includes a host of bipartisan odd couples.

President Obama's nominee for a top healthcare post won bipartisan approval Tuesday from the Senate Finance Committee.