Tag: "Medicare"

A Better Way to Slow Medicare

A report that will be released this week by the American Enterprise Institute finds that competitive bidding can save more money than the President’s budget proposals without endangering the care of millions of seniors. The authors—Roger Feldman of the University of Minnesota, Robert Coulam of Simmons College, and Bryan Dowd of the University of Minnesota—estimate that competitive bidding that includes all Medicare plans could save $339 billion over a decade. That is the approach taken by Sen. Ron Wyden (D-Ore.) and Rep. Paul Ryan (R-Wis.) in their bipartisan Medicare reform proposal.

Better yet, these savings reflect what health plans already say they can do. They are based on the actual bids of Medicare Advantage plans and the actual cost of traditional Medicare to provide full benefits without scrimping on health services.

Full article by Joseph Antos. AEI study here.

Feb 16, 2012 | 4 comments | by

Portfolio Risk Connected to Genetics, and Other News

Take the Medicare quiz. I missed one.

Studies of professional traders have demonstrated that about 25% of individual variation in portfolio risk is due to genetics.

What college students think: It’s scary. (video)

Good news: hearing aids, eyeglasses, contact lenses exempt from the medical device tax. Thousands of other products are still in limbo.

Feb 09, 2012 | 2 comments | by

CBO: Pilot Programs Aren’t Working

The evaluations show that most programs have not reduced Medicare spending: In nearly every program involving disease management and care coordination, spending was either unchanged or increased relative to the spending that would have occurred in the absence of the program, when the fees paid to the participating organizations were considered.  Programs in which care managers had substantial direct interaction with physicians and significant in-person interaction with patients were more likely to reduce Medicare spending than other programs, but on average even those programs did not achieve enough savings to offset their fees….

Demonstrations aimed at reducing spending and increasing quality of care face significant challenges in overcoming the incentives inherent in Medicare’s fee-for-service payment system, which rewards providers for delivering more care but does not pay them for coordinating with other providers, and in the nation’s decentralized health care delivery system, which does not facilitate communication or coordination among providers.

Full report here. HT to Chris Jacobs. See Megan McArdle’s comments here.

Jan 19, 2012 | 5 comments | by

Headlines I Wish I Hadn’t Seen

Antioxidant vitamins, supplements do nothing to improve health: major, international study.

Mack Brown’s 2011 Salary as University of Texas Football Coach: $5.1 Million. Combined Value of Athletic Scholarships for University of Texas Football Team: $3.1 Million.

Blindfolded experts: The fiddles made by the old masters do not in fact sound better than high-quality modern instruments.

The share of large insurers’ revenues contributed by their Medicare and Medicaid business has jumped from 36 to 42 percent over the past three years.

Jan 06, 2012 | 5 comments | by

How Doctors Get Paid

By Medicare, that is. This is courtesy of Jason Shafrin who has a terrific blog called the Healthcare Economist. As for what follows, I don’t know whether to laugh or cry:

  • For many procedures, Medicare pays providers for the professional and technical component. The professional component is the physician’s work and expertise; the technical component provides reimbursement for equipment and supplemental staff needed to perform the procedure. If the procedure is billed globally, then the physician receives both components. If another entity performed the technical component, then the physician is only paid for the professional component. For instance, for lab tests, the lab may run the test (technical component) but the physician would be the one interpreting the test (professional component).
  • If you assist in a surgery, you receive 16% of the fee the primary surgeon does.Under some circumstances, the individual skills of two surgeons are required to perform surgery on the same patient during the same operative session. If you are a co-surgeon (rather than an assistant at surgery), you receive 62.5% of the typical reimbursement for that surgery.

Read More » »

Jan 05, 2012 | 5 comments | by

Medicare Cost Increases Drop

One of the (very few) successes in health care this year was described by Lori Montgomery in a major article in The Washington Post. This was a substantial drop in the growth of Part B Medicare costs. Although they usually grow by 4% a year, they are now growing at a mere 2%. Everyone she spoke to is baffled. She writes:

At first, chief Medicare actuary Rick Foster thought it was a mistake, perhaps a glitch in data collection. No other explanation made sense. Congress had just passed far-reaching health-care legislation that mandated cuts in Medicare spending. But the law was so new that rules for implementation had not been written.

She goes on to interview a host of people who couldn’t explain it. Some speculated that it is the recession. Others (Democrat politicians) thought it is the salutary effect of Obama’s health care law. Still others argued that this shows how efficient the Medicare program is.

Read More » »

Jan 05, 2012 | 15 comments | by

Putting Everything Out to Bid

One of the main advantages of Medicare FFS [fee for service] is that beneficiaries do not need a referral for any services and are not limited to certain provider networks. However, Medicare beneficiaries do not pay for these added benefits. In addition, even if HMOs are more efficient than Medicare FFS, Medicare FFS beneficiaries still pay the same Part B premiums.

The authors want beneficiaries to face the true price differentials between the lowest cost plans and less efficient plans, regardless if the plan is Medicare FFS or an MA plan. Thus, beneficiaries would be responsible for any premium differences due to choosing a more expensive plan.

This is from Jason Shafrin’s review of Robert F. Coulam, Roger Feldman and Bryan E. Dowd’s new book, “Bring Market Prices to Medicare: Essential Reform at a Time of Fiscal Crisis” (American Enterprise Institute).

 

Dec 30, 2011 | 6 comments | by

John Goodman’s Health Policy Blog’s 10 Most Popular Posts from 2011

  1. What Most Needs Repealing and Replacing
  2. Health Problem Quantified
  3. Is Medicare a Good Deal?
  4. Bad News for ObamaCare
  5. Are Market-Oriented Economists Wrong About Health Care?
  6. Krugman Gets It Wrong Again
  7. Is RomneyCare Different from ObamaCare? This one was written by one of our talented guest authors, Linda Gorman.
  8. Why Do We Need Unions?
  9. What Is a Progressive?
  10.  HSAs vs. HRAs: Which is Better? This was written by another talented guest author, Greg Scandlen.

 

Dec 30, 2011 | 6 comments | by

What Difference Do Advance Directives Make?

The results were surprising: The advance directives only saved money in areas where Medicare’s end-of-life costs are high. Think Florida and New York. In areas where Medicare’s costs are already low — say, Minnesota — there was no change in spending….

The big difference, in fact, was that patients with end-of-life directives in high-costs areas were more likely to die outside of the hospital than patients who didn’t have end-of-life directives. That suggests the end-of-life directives do not prevent emergency measures at the end of life. If a patient is about to die, doctors try and save them. But in a non-emergency context, when doctors have time to talk with the patient’s family about treatment options, they do prevent certain types of life-prolonging treatment.

Ezra Klein post. Study here [gated, but with abstract].

Dec 29, 2011 | 5 comments | by

What Happened to the Federal Risk Pools?

This is Sarah Kliff (at Ezra Klein’s blog):

The crowds never showed and the program’s enrollment has lagged far behind projections. The chief actuary for Medicare initially estimated that 375,000 people would sign up by the end of 2010. As of Oct. 1, only 41,427 have enrolled.

A new report from the Government Accountability Office explores why that happened, suggesting that the speed and intensity with which the program was rolled out may explain the dismal enrollment numbers.

I have a different explanation: We have made it so easy for people to get insurance after they get sick that the need for a risk pool isn’t all that great.

Dec 29, 2011 | 11 comments | by
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