Posts Tagged ‘reimbursements’

MedPAC Seeks Reimbursement Increase

Monday, May 16th, 2011

The Medicare Payment Advisory Committee (MedPAC) has proposed that Congress raise physician payment rates for both hospital inpatient and outpatient services by one percent next year.   The independent advisory agency has also asked Congress to require the Secretary of Health and Human Resources (HHS) to adjust future payment rates to recover all over-payments resulting from documentation and coding enhancements.  Office visits, surgical procedures and therapeutic services will be covered, according to MedPAC policy analyst Cristina Boccuti.  Boccuti emphasized the “mounting frustration” from patients and providers, thanks to temporary fixes and coming reductions to the sustainable growth rate payment formula.

The Premier healthcare alliance commends the Medicare Payment Advisory Commission for its recommendation of a full market-basket update for inpatient and outpatient Medicare payments,” said Blair Childs, Premier senior vice president of Public Affairs, a performance improvement alliance of more than 2,400 U.S. hospitals and 72,000-plus other healthcare sites using the power of collaboration to lead the transformation to high quality, cost-effective care.   “Such a recommendation signals to Congress that flat reductions in payment, rather than savings generated from delivery system reform, are imprudent given the poor state of the national economy.  MedPAC estimates that Medicare reimbursements are nearly six percent below cost, and a full market basket update is a minimum step required to ensure the continued patient access to non-profit hospitals.  Congress should consider these realities as it finalizes the historic healthcare reform legislation.”

Primary Care On the Rise Among Medical Students

Monday, April 18th, 2011

More American medical school seniors will begin residency training in primary-care or family medicine in July, marking an 11.3 percent increase over last year and the second consecutive year of growth in the practice, according to the National Resident Matching Program (NRMP).  Medical school seniors filled 1,301 family medicine positions this year, a significant increase over the 1,169 who chose primary care in 2010.  This year, 48 percent of available family medicine positions were filled, an increase over the 44.8 percent in 2010.  Internal medicine matches rose eight percent, to 2,940 from 2,722, also showing an increase for the second year in a row.  This year, 57.4 percent of available internal medicine residency positions were filled, an increase over the 54.5 percent reported in 2010.

“We were pleased that this year’s Match was able to offer more positions,” Mona M. Signer, NRMP executive director, said.  “There will no doubt be wonderful cause for celebration at the nation’s medical schools today and for all participants as they experience this defining moment in their careers as physicians.”

“This is good news for internal medicine and adult patient care in the U.S.,” said J. Fred Ralston, Jr. MD, FACP, president of the American College of Physicians (ACP).  “The American College of Physicians has consistently called for healthcare reforms that support internal medicine as a career path, including increasing support for primary care training programs, increasing Medicaid and Medicare reimbursement to primary care physicians, and expanding pilot testing and implementation of new models of patient care.”  Although the ACP is enthusiastic about the trend that sees more students choosing internal medicine for their residencies, the organization warns that expanding the number of primary-care physicians is still a long way from its goal of meeting the needs of an aging population who require care for chronic and complex illnesses.  “We’re cautiously optimistic and hope that the positive trend continues,” said Steven Weinberger, MD, FACP, executive vice president and CEO, ACP.  “But the U.S. still has to overcome a generational shift that resulted in decreased numbers of students choosing primary care as a career.  In 1985, 3,884 U.S. medical school graduates chose internal medicine residency programs.  And the 18.9 percent of U.S. seniors that matched internal medicine in 2011 is the same percentage as 2007.”

At Meharry Medical College in Nashville, half of the 98 graduating students opted for primary-care specialties.  Additionally, many Meharry students chose internal medicine, pediatrics, ob/gyn and family medicine.  “At Meharry, we proudly embrace and emphasize primary care as a very worthy career pursuit for future physicians,” said Charles P. Moulton, M.D., M.S., and Dean of the School of Medicine and Senior Vice President for Health Affairs.  “The fact that so many of our students go into the primary-care field is a tribute to our unique and nurturing brand of medical education, our institution and its role in helping to fill the increasing need for primary-care physicians across the country.”  At Meharry, 10 students matched in family medicine; 17 in internal medicine; 16 in pediatrics; and six in ob/gyn.

Ronald Goertz, M.D., M.B.A., president of the American Association of Family Physicians was heartened by the news, saying that the increases suggest growing interest in the specialty among U.S. medical school graduates. “This year’s results mark the second consecutive year of increased interest in family medicine.  “Although several factors likely contribute to the increase, we believe an important element is recognition that primary care medicine is absolutely essential if we are to improve the quality of health care and help control its costs.  Of course, sustaining this interest will require continuing changes in the way America pays for and delivers health care to patients.”

Dr. David Donnersberger on Solving the Primary Care Crisis

Wednesday, November 3rd, 2010

Is concierge medicine the answer to healthcare?  Listen to Dr. David Donnersberger’s podcast.  Physicians who practice concierge medicine are reimbursed for spending significant time with their patients, knowing them extremely well and following them closely through every hospitalization.  This is the opinion of Dr. David Donnersberger, an internal-medicine specialist in private practice in Winnetka, IL, who is affiliated with the University of Chicago’s Pritzker School of Medicine.  In a recent interview for the Alter+Care Inspire Podcasts, Dr. Donnersberger described boutique or concierge VIP medicine as a return to a personal approach to healthcare where the physician knows the patient, their social situation and their health history.

In concierge practices, patients pay a flat annual fee and receive an expanded suite of services that includes the ability to call the physician on his cell phone at any time, obtain same-day appointments and – most importantly – receive personal care from the primary-care doctor when hospitalized.  Dr. Donnersberger notes that the current reimbursement system pays more to the radiologist and the radiology department for a chest X-ray than for an hour-long conversation and annual physical exam of the patient in the doctor’s office.  He believes that more information can be gleaned from that extensive conversation and physical exam, and serves as the starting point for years of personalized healthcare.

Practitioners of concierge medicine tend to have smaller practices than other physicians.  While a typical primary-care physician may have 2,000 to 2,500 patients, Dr. Donnersberger and his three partners have a smaller load of between 1,200 and 1,500 individuals.  Dr. Donnersberger’s practice is a hybrid – one which accepts patients who pay the upfront flat fee as well as others who rely on their healthcare insurance for reimbursement.  Concierge medicine’s most powerful tool is its ability to control costs.  Knowledge of a patient’s medical history can save money because the physician is keenly aware of pre-existing conditions that become crucial whenever that individual is hospitalized. This in-depth knowledge also saves the healthcare system thousands of dollars of workups that otherwise would have to be performed.

 
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Healthcare Reform Will Save Billions for Medicare

Monday, August 16th, 2010

Healthcare reform will save Medicare $418 billion over the next 10 years.

The healthcare reform bill is expected to save Medicare $7.8 billion through 2011 and $418 billion over the next decade, according to a report released by the Centers for Medicare and Medicaid Services (CMS).  Kathleen Sebelius, Health and Human Services Secretary, said “Because we began making changes right away, the savings from Medicare add up fast.”

The CMS report focuses largely on the measures that will change how healthcare is delivered and paid, which are at the heart of the historic legislation passed by Congress in spring.  Some of the programs are designed to cut the number of hospital re-admissions, find new ways to reimburse hospitals and physicians, and target fraud and abuse.  The last is expected to save Medicare billions.

Sebelius believes that Medicare will lead the private sector in reforming how healthcare is delivered.  Jonathan Blum, deputy administrator of CMS, said “I think when you look at the history of hospital and provider payments, when large payers like the Medicare program place continued financial pressure, hospitals become more productive.”

According to CMS estimates, changed to the Medicare Advantage programs and the ways in which the agency will reimburse providers will save $145 billion and $205 billion over the next decade respectively.  The report also highlighted several changes that affect care delivery.  As an example, actions to improve quality and simplify care are expected to save more than $15 billion.

Recession Forces Physicians to Rethink Retirement

Tuesday, June 16th, 2009

The recession and its impact on investment portfolios, as well as declining Medicare and Medicaid reimbursements, are making physicians rethink their retirement dates.

Some physicians have seen their stock markets portfolios fall by as much as 50 percent.  In today’s economy, selling practices might not bring the anticipated profit, according to William Jessee, M.D., president and CEO of the Medical Group Management Association.  “I look at my 401(k) and think ‘Okay, I just turned 62, and 70 is starting to look like a better retirement field,’” Dr. Jessee said.20071003_nest_egg_18

A 2007 survey of 1,200 physicians found that 48 percent aged 50 to 65 were planning to retire, find non-clinical jobs, work part-time, close their practices to new patients and/or substantially reduce their patient load.  Since the survey was conducted, Americans’ retirement funds have lost as much as $2 trillion.

“It has not been entertaining watching all my hard-earned money disappear,” according to Jeffrey Sankoff, 41, a Denver physician.  “But I’ve got about 10 to 15 years before I need to worry because my 401(k) will just sit there and eventually recover and grow.  Those physicians closer to retirement age – hopefully their portfolio is balanced in such as way that this catastrophe won’t have as big of an impact as it’s had on me.”

The silver lining in these deferred retirements is that they could prevent a physician shortage, a result of medical schools capping their enrollments at 16,000 students per year because they believed that managed care would create a glut.  It is estimated the shortage could be as much as 250,000 physicians in the next 10 years.

The Healthcare Village: Making Good Health More Convenient

Friday, April 17th, 2009

With 78 million baby boomers marching towards retirement, the U.S. population is older and less healthy as cases of obesity, diabetes and other chronic diseases increase, says Donna F. Jarmusz, Alter+Care Senior Vice President, in a recent interview for the Inspire blog.  These same consumers dislike inconvenient, institutional healthcare delivery systems, are demanding and have high expectations.  We have a drive-through mindset and enjoy everyday consumer experiences– buying a cup of coffee, drive-up banking, picking up dry cleaning.  We hardly think about them because they’re all convenient and accessible.
Consumers are looking for a similar consumer focus in their healthcare services.  They are also looking to healthcare providers for preventative health resources to achieve healthier lifestyles.

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