Navigation Links
Healing cuts for Medicare
Date:9/4/2012

Medicare payment reforms mandated in the Affordable Care Act (ACA) for postacute care have great potential to lower costs without harming patients, a new study reports.

However, researchers caution, policymakers will need to be vigilant to ensure that these cuts don't result in one-time savings that revert to rising costs.

"We expect that the Affordable Care Act's dramatic cuts in payments to providers for postacute care will lead to decreased utilization and lower spending," said David Grabowski, Harvard Medical School professor of health care policy and lead author of the study. "Our work suggests that those changes will not have a dramatic effect on outcomes, based on analysis of patient mortality and hospital readmissions under previous cuts."

These findings are reported in the September issue of Health Affairs.

Each year, more than 10 million Medicare beneficiaries are discharged from acute care hospitals into postacute care settings: long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities and patients' homes with services from home health agencies.

"These four sectors were among the fastest growing part of the Medicare program during much of the nineties," Grabowski said. Despite several efforts to curb spending, postacute care remains a major driver of rising Medicare costs.

ACA-mandated changes in payments for Medicare postacute care services are intended to contain spending in the long run and help ensure the program's financial sustainability. In addition to reducing annual payment increases to providers, the act calls for bundled payment models, accountable care organizations and other strategies to promote care coordination and reduce spending.

The researchers studied the effects of payment reforms from 1997, 1998 and 2002. The group also analyzed Medicare claims data to measure the impact of reforms on patient mortality and hospital readmissions for postacute care recipients.

Each of these previous payment reforms caused a steep downtick in postacute care costs immediately after implementation. However, expenses quickly resumed their upward trend as reimbursements were renegotiated and providers changed the ways they managed patient care.

The researchers recommend that policymakers will need to be vigilant in monitoring the impact of the ACA reforms and be prepared to amend policies as necessary to ensure that the reforms exert persistent controls on spending without compromising the delivery of patient-appropriate postacute services.

In the mandated demonstration projects, providers and health care systems are experimenting with different models of payment that all aim to lower costs, for example, providing a lump sum per patient per year, or a single fee for a healthy recovery from an illness or injury to be shared among physicians, hospitals and postacute care facilities.

"If it works the way it's meant to, patients will use only those services that are the most efficient," Grabowski said. That could mean moving patients from high-cost skilled inpatient rehabilitation facilities to lower-cost skilled nursing facilities. It could also mean that providers find creative new ways to avoid costly treatments altogether, like inspecting homes for tripping hazards to prevent painful and costly falls. In the current system, there's no incentive for providers to perform these kinds of interventions, he said, since Medicare has no mechanism to reward these kinds of savings.

"The overall goal of these experiments is to find ways to improve overall care and make services more cost effective. In any system this complex, there are always going to be tradeoffs, so monitoring results closely to minimize any issues will be critical," Grabowski said.


'/>"/>

Contact: David Cameron
david_cameron@hms.harvard.edu
617-432-0441
Harvard Medical School
Source:Eurekalert

Related medicine news :

1. Zebrafish reveal promising mechanism for healing spinal cord injury
2. Minorities, Medicare Recipients Less Likely to Get Antidepressants
3. Study examines medicare use for Mohs micrographic surgery and surgical excision for skin cancer
4. Seniors Stop Taking Heart Drugs In Medicare Donut Hole
5. Americans Support Medicare Reform, But Not on Their Dime: Poll
6. AMA committee recommendations on doctor fees set by Medicare are followed 9 times out of 10
7. ACP applauds introduction of bipartisan bill to eliminate Medicare SGR formula
8. Safer kidney cancer surgery under-used for poorer, sicker Medicare, Medicaid patients
9. Under pressure from Medicare, hospitals hold more seniors for observation
10. Feinstein Institute to Receive Grant from Centers for Medicare & Medicaid Services to Improve Schizophrenia Treatment
11. Study answers Medicare concerns about paying for CT colonography
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/2/2016)... ... May 02, 2016 , ... MedaCheck, a leading medication ... outcomes, has announced its partnership with GrandView Health Services. , With decades of ... counter and prescription drug pharmacy services to thousands of residents. Serving Indiana, Ohio, ...
(Date:5/2/2016)... TN (PRWEB) , ... May 02, 2016 , ... ... and behavioral health services, today announced the opening of Twin Lakes Recovery Center. ... will be Summit’s first in the state. The residential facility is set ...
(Date:5/1/2016)... (PRWEB) , ... May 01, 2016 , ... Women's Excellence ... Essential Oils and taught by Patti Dolan, a Young Living Gold Member. , The ... 6:30pm - 7:15pm followed by a small intro to the Oils that can benefit ...
(Date:4/30/2016)... (PRWEB) , ... May 01, 2016 , ... Serenity Recovery, ... to rehabilitation, has produced a new video that focuses on one of the more ... recent sessions and clips from interviews with a participating patients and the Yoga class ...
(Date:4/30/2016)... , ... April 30, 2016 , ... ... Boise, President and CEO of EMED, today signed a multifaceted agreement which will ... and the Northern Caribbean University Department of Natural and Applied Sciences, Allied Health ...
Breaking Medicine News(10 mins):
(Date:4/28/2016)... 2016   Click here for supplemental information ... DPLO), the nation,s largest independent specialty pharmacy, announced ... to acquire Valley Campus Pharmacy, Inc., doing business ... specialty pharmacy that provides individualized patient care, based ... In 2015, TNH generated approximately $400 million in ...
(Date:4/28/2016)... , April 28, 2016  The blood testing market ... dollars, according to Kalorama Information and The Freedonia Group ... and nucleic acid testing.  The healthcare research firm said ... in developing blood collection stations and in improving testing ... Kalorama Information,s report, Blood Testing Market in ...
(Date:4/28/2016)... N.J. , April 28, 2016   Acsis ... today announced that leading IT market research and advisory ... " in the IDC MarketScape: Worldwide Pharmaceutical Track and ... 2016).  The report provides an assessment of the capabilities ... track and trace software market. Logo - ...
Breaking Medicine Technology: