Medicare To Change How It Pays Hospitals For Knee Hip Replacements

first_img Also, a look at payments for Medicare Advantage – The U.S. agency that runs federally funded health insurance programs has proposed restructuring payments for hip and knee replacement surgeries, some of the most common surgeries received by patients covered by the plans. The Centers for Medicare and Medicaid Services (CMS) invited providers on Thursday to comment on a proposal that would hold hospitals in 75 geographic areas accountable for the quality of care they deliver to Medicare fee-for-service beneficiaries for hip and knee replacements from surgery through recovery. (Beasley, 7/9) USA Today: Feds Want To Penalize Hospitals With Too Many Hip, Knee Surgery Problems The Wall Street Journal: Medicare Plans To Fix Rates On Knee, Hip Replacements Reuters: U.S. Proposes Bundling Some Medicare Knee, Hip Replacement Payments Government audits just released as the result of a lawsuit detail widespread billing errors in private Medicare Advantage health plans going back years, including overpayments of thousands of dollars a year for some patients. Since 2004, private insurers that run Medicare Advantage plans, an increasingly popular alternative to traditional Medicare, have been paid using a risk score calculated for each patient who joins. Medicare expects to pay higher rates for sicker people and less for those in good health. But the internal audits, never before made public, provide striking new evidence of billing mistakes — mostly overcharges — in the Medicare Advantage plans. (Schulte, 7/10) Medicare wants to start paying hospitals fixed amounts for hip and knee replacements, rather than letting providers bill individually for each surgical and recovery service provided to older Americans, health officials said Thursday. The proposal, which would apply to two of the most common procedures for Medicare beneficiaries, is another step by the Obama administration to try to curb costs in the insurance program for people 65 years old and older as well as the disabled. (Radnofsky and Armour, 7/9) The Washington Post: Medicare Proposes Payment Changes To Hospitals For Hip, Knee Replacement Andy Slavitt, the acting administrator of the Centers for Medicare and Medicaid Services, which oversees the Obamacare healthcare program, has been nominated as head of the agency, the White House said on Thursday. Slavitt, who joined CMS last year to oversee the once-troubled HealthCare.gov website, has been acting administrator since March following the resignation of Marilyn Tavenner as head of the agency that also manages the Medicare and Medicaid government healthcare programs. He was previously an executive at a government contractor working on the HealthCare.gov site and a leader of the rescue team that turned it around after a botched rollout. (Cooney, 7/9) center_img Federal health care regulators on Thursday proposed cutting Medicare payments to hospitals with high rates of complications for hip or knee replacements. The proposed rule, announced by the Centers for Medicare and Medicaid Services, will affect more than 800 hospitals in both large and small cities, including New York City, Los Angeles, Flint, Mich., and Lubbock, Texas. (O’Donnell, 7/9) Medicare To Change How It Pays Hospitals For Knee, Hip Replacements Under the plan, hospitals will not bill individually for surgical and recovery services but will instead get a single payment for the procedure and follow-up care. Reuters: Obamacare Acting Administrator Slavitt Nominated To Head Agency NPR/Center for Public Integrity: Federal Audits Of Medicare Advantage Reveal Widespread Overcharges Federal health officials are proposing a major change in the way Medicare pays for hip and knee replacements, requiring hospitals to partly repay the government if patients get avoidable infections and other complications but rewarding them with extra payments if patients do well. The proposal announced Thursday by the Centers for Medicare and Medicaid Services is part of the Obama administration’s efforts to overhaul the health-care system, in part by using the payment system to reward quality of care rather than volume of services. Under the current system, doctors and hospitals typically get paid set fees for every procedure they perform, regardless of how patients fare. (Sun, 7/9) The administration also announces its choice to head the agency overseeing Medicare, Medicaid and the federal health law – This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.last_img