Medicare

One hospital charges $160,832 for a lower joint replacement; another charges $42,632.

The chairman of a key House subcommittee said Tuesday that he's optimistic about the chances Congress could pass a bill this year to replace Medicare's payment formula for doctors.

Rep. Kevin Brady (R-Texas) said he believes the House is about halfway toward a solution. He said there's no firm timeline to pass a permanent "doc fix," but that he's hoping to finish a bill as soon as possible.

"I think it would be a huge mistake to run this up to New Year's Eve again," Brady said in an interview with The Hill.

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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.  

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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.