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Posts tagged: Reimbursement

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Moody's warns exchanges could carry more short-term risk than benefit


A credit analyst for not-for-profit healthcare providers is cautioning that the new state health insurance exchanges may introduce more short-term risk than benefit.

Moody's Investors Service said in a report Friday that while the exchanges may lead to a bump in the number of insured patients, the larger unknowns will be what happens with insurance contract terms; the potential migration of patients who currently have private insurance to exchange plans; and bad debt for patients.
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RWJF backs publication of Medicare physician data


The Robert Wood Johnson Foundation has joined the entities urging the CMS to publish the Medicare earnings and de-identified clinical data of individual physicians. But the foundation stopped short of calling for widespread public release to any interested party.

In recent years, the CMS has published several datasets for the first time, including average hospital charges for common Medicare treatments and the prescribing patterns of doctors in Medicare's drug-benefit program. Now a ruling this year in a 30-year-old lawsuit is prompting the agency to consider releasing a long-sought dataset that would show how individual doctors care for and are paid to treat patients on Medicare.
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Researchers find $56K pay gap for female docs

2:15 pm, Sep. 3 |

Though the gender earnings gap has been narrowing across most professions, sharp salary inequities persist among physicians, according to a research letter published in JAMA Internal Medicine.

Researchers analyzed data—occupation, hours worked, annual earnings, age, sex and race—from the March Current Population Survey to identify trends in male and female pay among physicians, other healthcare professionals and workers overall.
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ACA provision may alter dynamic between docs, sales reps


Have you heard this joke before?

How do you know when a total joint implant sales rep is at the hospital? When the orthopedic surgeons' cars aren't the nicest ones in the parking lot.
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90% of not-for-profit hospitals get Medicare payment adjustments, GAO study shows


Greater proportions of not-for-profit and government hospitals than for-profit hospitals qualified for at least one category of Medicare payment adjustments last year, according to new findings from the Government Accountability Office.

About 97% of government-owned hospitals and 90% of not-for-profit hospitals paid by the Medicare program received at least one form of increased payment to the standard inpatient prospective-payment system last year.
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Bipartisan effort revives measure that some conservatives branded 'death panels'


Nearly every expert and group that has looked at how to control U.S. medical cost growth says more Americans should fill out advance directives to help reduce costly futile care at the end of life. In 2009, there was some bipartisan support in Congress for having Medicare pay physicians for their time in counseling patients on living wills and end-of-life care. Sen. Johnny Isakson (R-Ga.) pushed for inclusion of the provision in the healthcare reform legislation.

But Sarah Palin and other conservatives twisted this into “death panels,” accusing President Barack Obama and the Democrats of trying to throw granny off the cliff. Terrified Democratic sponsors of the reform legislation yanked the provision. But the death panel myth helped fuel the rise of the Tea Party and the Republican takeover of the House in 2010.
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McDermott wants to lessen providers' role in setting Medicare fees


McDermott
Rep. Jim McDermott (D-Wash.) wants to reduce organized medicine's role in setting Medicare fees. But such legislation is likely to face stiff resistance from the American Medical Association and subspecialist physician groups, who are heavily represented in the fee-setting process.

McDermott has introduced legislation that he said will address “the lack of transparency and fairness” in setting the Medicare fee schedule and lessen the CMS' reliance on guidance from the AMA's Specialty Society Relative Value Scale Update Committee—commonly referred to as “the RUC.”
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