More patients are being admitted to hospitals because of complications from surgery or medical treatment, according to HHS' Agency for Healthcare Research and Quality. The number of patients with such complications rose from 305,000 in 1993 to 452,000 in 2003, the agency stated in a news release. Of these, the number admitted through hospital emergency departments rose from 98,000 in 1993, or 32 percent of all cases, to 211,000 in 2003, or 47 percent of all cases. Read more »
Medicare officials are downplaying a drug benefit snafu reported this week—that "tens of thousands" of beneficiaries who have switched drug plans are now actively enrolled in two plans simultaneously. Centers for Medicare and Medicaid Services spokesman Gary Karr said Friday he does not know how many beneficiaries fall into that category. But Karr said the "vast majority" of Medicare beneficiaries who have switched drug plans aren't harmed by being simultaneously enrolled for a time in two plans. But the New York Times reported that the situation leaves beneficiaries at risk of being charged premiums twice in a month, or of having to pay higher copayments when they get prescriptions filled. Read more »
Policymakers must take a series of steps now to control federal Medicare spending or face an unfunded liability five times worse than Social Security over the next 75 years, Senate Majority Leader Bill Frist, R-Tenn., said. "The demographic aging revolution dictates that the spending path we're on is unsustainable," Frist said in remarks at the Detroit Economic Club. Read more »
House Ways and Means Health Subcommittee Chairman Nancy L. Johnson, R-Conn., gave a chilly reception Wednesday to cuts in Medicare hospital spending growth advocated by the Medicare Payment Advisory Commission (MedPAC). Those recommended cuts are at the heart of a proposal by the Bush administration to trim Medicare spending this year. Her remarks won't dispel the impression that key lawmakers aren't keen on cutting Medicare this year. Read more »
"The SGR" and "P4P" may be the hottest issues in the arcane world of Medicare physician payment, but "RVUs" are sexy too, says a report given to Congress on Wednesday by the Medicare Payment Advisory Commission (MedPAC). Jargon aside, the first two issues relate to the method of calculating the yearly Medicare payment rate to doctors and the effect that the quality of a doctor's care should have on payment, while RVUs are all about "fair" payment—and concern that payments for primary care may be falling too far behind. At a breakfast meeting with reporters Wednesday, MedPAC Chairman Glenn Hackbarth said the commission is urging changes in the way Medicare figures out how much to pay for one type of care compared with another. The technical procedure for doing that is assigning "Relative Value Units," or RVUs. Read more »
The Senate Health, Education, Labor and Pensions (HELP) Committee has scheduled a markup for legislation this week that may break the logjam of proposals to permit small businesses to pool their purchasing power and buy insurance for their workers. "Working with a diverse group of senators and business groups representing small business, we've bridged the gap between small business proponents of traditional AHPs (association health plans) and state-based interests worried about the prospects of dramatic regulatory changes in health insurance markets," HELP panel chairman Michael B. Enzi, R-Wyo., said in a statement. Read more »