Unbiased Analysis of Today's Healthcare Issues
The Medicare Reimbursement Series Continues. The sources of this information is MedPAC’s Payment Basics. Clinical Laboratory Services: Under Part B, Medicare covers medically diagnostic and monitoring laboratory services ordered by a physician. Medicare does not cover routine screening tests except for cholesterol and blood lipid tests, fecal occult blood testing, Pap smear tests, prostate-specific antigen…
Today, we will focus on hospital care outside of the traditional Inpatient hospital care setting. Again, this information is culled from MedPAC reports. Outpatient Hospital Services Outpatient hospital care, from injections to complex procedures, accounted for $19 billion of total Medicare spending in 2007 Originally, outpatient reimbursement was cost based and copayments amounted to about…
I will continue reviewing some Medicare reimbursement information as described in a variety of MedPAC reports. Medicare Advantage Medicare Advantage is a program where Medicare beneficiaries can receive private heath insurance, partially or fully funded by CMS. The health insurance must provide coverage at least as generous as Medicare Parts A and B. Private health…
This week, I will be discussing Medicare Reimbursement in detail. The Medicare Payment Advisory Commission (MedPAC) has a high-quality series of reports analyzing Medicare’s reimbursement system. Findings from these reports includes: Physician Services In 2006, about 569,000 physicians billed Medicare. In 2007, Medicare paid $60 billion for physician services. All physician services are reported to…
Historically, Medicare recipients in their final year of life generated about six times the expenditures of the average surviving Medicare enrollee and accounted for almost 30 percent of total program spending. However, in the late 1980s, a confluence of two forces helped increase the use of hospice care among Medicare beneficiaries. First, in 1984, Medicare…
The Congressional Budget Office (CBO) periodically releases its 75-year health care spending projections. Current projections forecast the following health care spending levels: Total spending on health care would rise from 16% of GDP in 2007 to 25% in 2025, 37% in 2050 and 49% in 2082. Federal spending on Medicare (net of beneficiaries premiums) and…
Health Reform is at the top of President Obama’s list of reform efforts. Mr. Obama claims that not only will health reform improve the physical health of the nation, it will also improve its economic health. In a Council of Economic Advisers Report, President Obama lists three reasons why slowing health care costs and expanding…
On the need to count the deadweight loss from additional taxation as part of Medicare’s administrative cost. Are arguments for Medicare’s lower administrative costs the same ones used to justify socialism? Would efficiency improve if Medicare administrative costs were higher?
President Obama addressed the American Medical Association in Chicago today. His goal was push through his health care reform agenda. On Saturday, his Weekly Address also focused on health care reform. What is this agenda and how will it be paid for? Obama wants a public health care plan for the uninsured. The total cost…
Survey estimates of Medicaid enrollment are 43 percent lower than raw Medicaid program enrollment counts. Why is this the case? Roebuck and Liberman (HSR 2009) find that many people are not reporting that they have Medicaid coverage. “43 percent of Medicaid enrollees answering the CPS as though they were not enrolled and 17 percent reported…