Navigation Links
Medicare reimbursement change meant to save money has opposite effect
Date:2/8/2010

ATLANTA-Feb. 8, 2009-Increased Medicare payments to physicians for outpatient surgeries for bladder cancer have led to a dramatic rise in the number of these procedures being performed and an overall increase in cost to the healthcare system. That is the conclusion of a new study published early online in Cancer, a peer-reviewed journal of the American Cancer Society. The findings indicate that some Medicare policies aimed at decreasing costs may instead be contributing to an increase in healthcare expenditures.

Because bladder cancer is the most expensive cancer to treat, its management places a significant economic burden on the United States healthcare system, which costs two to four times that of healthcare systems in any other industrialized nation. In an attempt to reduce costs, in 2005 Medicare increased physician reimbursement for office-based endoscopic bladder procedures, such as biopsies. Moving these procedures from the more expensive inpatient hospital setting to the presumably less expensive outpatient office setting could cut costs provided that they are performed for the same indications, are equally efficacious, and are tolerable to patients.

The reimbursement change was expected to alter physician incentives, leading to increased use of outpatient endoscopic surgery, a decline in hospital-based endoscopic surgery and, consequently, a reduction in healthcare-related costs. To evaluate this hypothesis, Micah Hemani, MD, and Samir Taneja, MD, of the Division of Urologic Oncology at the New York University Langone Medical Center and their colleagues assessed treatment patterns in their practice before and after the Medicare change in physician reimbursement.

The investigators found that the number of outpatient bladder surgeries doubled after Medicare reimbursements rose, but the number of hospital-based surgeries did not significantly decline. As a result, there was a 50% increase in overall Medicare costs. While there was an increase in patient referrals for outpatient surgeries, it was not sufficient enough to account for the increased use of these procedures. There was, however, a rise in the redundant use of outpatient surgery on patients who also underwent hospital-based surgery for the same condition. Also, while the number of outpatient procedures increased, the likelihood that a procedure would lead to a bladder cancer diagnosis declined. "We believe these trends are disturbing as they may reflect both diagnostic and therapeutic over-utilization of office-based endoscopic bladder surgery," the authors wrote.

The reasons for this surge in use of outpatient procedures are unknown but might include improvements in office-based equipment for surgery, improved physician comfort and skill with these operations, and the incentive of receiving increased financial reimbursement. Whatever the cause, these findings suggest that Medicare financial incentives for the outpatient treatment of bladder cancer may actually increase overall costs without improving care.

Dr. Hemani noted that the study's results illustrate a need for clinical guidelines for these office-based surgeries, as well as a need for policy measures that ensure accountability for physicians who perform them.

"Given the ongoing healthcare debate in Congress regarding reforming the current system, one wonders if many of the changes currently being proposed in Washington might not have similar effects to what we are seeing in this one isolated example," said David Penson, MD, MPH, of Vanderbilt University in Nashville, who was not involved with the study but wrote an accompanying editorial. "Sometimes, policies have the exact opposite effect of what was intended," he cautioned.


'/>"/>

Contact: David Sampson
david.sampson@cancer.org
American Cancer Society
Source:Eurekalert

Related medicine news :

1. Former Los Angeles Medical Center Owners Agree to $10 Million Consent Judgment For Medicare and Medi-Cal Fraud Scheme
2. Thirteen Detroit-Area Individuals Arrested and Charged for $14.5 Million Medicare Fraud
3. MessageBroadcast Launches Automated Medicare Survey System for NebDoctors of Nevada
4. Clinic Manager Pleads Guilty in Medicare Fraud Scheme
5. Top-Rated Medicare Plan Now Offers Silver Life Fitness Program Free to its Members
6. CMS Launches Fifth Annual Medicare Health Care Provider Satisfaction Survey
7. InComm and Medagate to Launch Government Backed Medicare Products
8. Blue Cross Blue Shield of Michigan Adds University of Michigan Health System to New Medicare Advantage PPO Network
9. Cardiology Takes Legal Action Against Medicare
10. New Study Shows That American Public is Willing to Accept Major Reforms in Medicare Program
11. Masimo Rainbow SET(R) SpHb(TM) Measurement Receives New CPT Code and Medicare Pricing
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/24/2017)... FL (PRWEB) , ... March 24, 2017 , ... ... Inc. ( http://www.hygieacare.com ) announced their partnership to prep patients for colonoscopy at ... Endoscopy Centers in 87th Ave., Miami, FL. , The HyGIeaCare® ...
(Date:3/24/2017)... ... 2017 , ... “Finding Christ Through Social Media: Year One ... the writer’s path toward true communion with God. “Finding Christ Through Social Media: ... creation of published author Lea Michelle Johnson, a follower of Christ, wife and ...
(Date:3/24/2017)... ... March 24, 2017 , ... “The Communion of ... people of God in congregations across the United States. “The Communion of ... in 1964 who has served congregations in seven states throughout his long career ...
(Date:3/23/2017)... CO (PRWEB) , ... March 23, 2017 , ... A ... bar for entry into teacher preparation programs. The NCTQ report suggests, based on a ... entry requirements would significantly improve teacher quality in the U.S. It argues that this ...
(Date:3/23/2017)... (PRWEB) , ... March 23, 2017 , ... Texas ... located at 960 Gruene Road in Building 2. The clinic is the group’s second ... Bennett, PT, says opening the company’s second New Braunfels location brings things full circle ...
Breaking Medicine News(10 mins):
(Date:3/23/2017)... The key factors driving the growth of dialysis ... growth and increasing healthcare expenditure. Some of the noteworthy trends ... ESRD patients, rising demand for home PD treatment and huge ... market is hindered by high treatment costs and stringent regulations. ... Complete ...
(Date:3/23/2017)... BARBARA, Calif. and INDIANAPOLIS ... (NYSE: LLY ) and the William Sansum ... the lives of Latino people affected by diabetes through ... tremendous burden of diabetes and cardiovascular disease bears a ... United States ," said David Kerr , ...
(Date:3/23/2017)... , March 23, 2017   BioSpace , ... resource, has partnered with Indiana Biosciences Research Institute ... organizations and educational institutions to bring the state,s ... first-ever BioIndiana Hotbed map, an artistic representation of the ... was presented to Vice President Mike Pence , ...
Breaking Medicine Technology: