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Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309258014
Category : Medical
Languages : en
Pages : 262
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Book Description
Medicare, the world's single largest health insurance program, covers more than 47 million Americans. Although it is a national program, it adjusts payments to hospitals and health care practitioners according to the geographic location in which they provide service, acknowledging that the cost of doing business varies around the country. Under the adjustment systems, payments in high-cost areas are increased relative to the national average, and payments in low-cost areas are reduced. In July 2010, the Department of Health and Human Services, which oversees Medicare, commissioned the IOM to conduct a two-part study to recommend corrections of inaccuracies and inequities in geographic adjustments to Medicare payments. The first report examined the data sources and methods used to adjust payments, and recommended a number of changes. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency applies the first report's recommendations in order to determine their potential effect on Medicare payments to hospitals and clinical practitioners. This report also offers recommendations to improve access to efficient and appropriate levels of care. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency expresses the importance of ensuring the availability of a sufficient health care workforce to serve all beneficiaries, regardless of where they live.
Author: United States. General Accounting Office
Publisher:
ISBN:
Category : Medical fees
Languages : en
Pages : 22
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Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309257980
Category : Medical
Languages : en
Pages : 262
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Book Description
Medicare, the world's single largest health insurance program, covers more than 47 million Americans. Although it is a national program, it adjusts payments to hospitals and health care practitioners according to the geographic location in which they provide service, acknowledging that the cost of doing business varies around the country. Under the adjustment systems, payments in high-cost areas are increased relative to the national average, and payments in low-cost areas are reduced. In July 2010, the Department of Health and Human Services, which oversees Medicare, commissioned the IOM to conduct a two-part study to recommend corrections of inaccuracies and inequities in geographic adjustments to Medicare payments. The first report examined the data sources and methods used to adjust payments, and recommended a number of changes. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency applies the first report's recommendations in order to determine their potential effect on Medicare payments to hospitals and clinical practitioners. This report also offers recommendations to improve access to efficient and appropriate levels of care. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency expresses the importance of ensuring the availability of a sufficient health care workforce to serve all beneficiaries, regardless of where they live.
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 188
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Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030921145X
Category : Medical
Languages : en
Pages : 236
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Book Description
Medicare is the largest health insurer in the United States, providing coverage for 39 million people aged 65 and older and 8 million people with disabilities, and reaching more than an estimated $500 billion in payments in 2010. Although Medicare is a national program, it adjusts fee-for-service payments according to the geographic location of a practice. While there is widespread agreement about the importance of providing accurate payments to providers, there is disagreement about how best to adjust payment based on geographic location. At the request of Congress and the Department of Health and Human Services (HHS), the Institute of Medicine (IOM) examined ways to improve the accuracy of data sources and methods used for making the geographic adjustments to payments. The IOM recommends an integrated approach that includes moving to a single source of wage and benefits data; changing to one set of payment areas; and expanding the range of occupations included in the index calculations. The first of two reports, Geographic Adjustment in Medicare Payment: Phase I: Improving Accuracy, assesses existing practices in regards to accuracy, criteria consistency, evidence for adjustment, sound rationale, transparency, and separate policy adjustments to reform the current payment system. Adopting the recommendations outlined in this report will mean a change in the way that the indexes are calculated, and will require a combination of legislative, rule-making, and administrative actions, as well as a period of public comment. Geographic Adjustment in Medicare Payment will inform the work of government agencies such as HHS, the Centers for Medicare and Medicaid Services, congressional members and staff, the health care industry, national professional organizations and state medical and nursing societies, and Medicare advocacy groups.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309211492
Category : Medical
Languages : en
Pages : 236
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Book Description
Medicare is the largest health insurer in the United States, providing coverage for 39 million people aged 65 and older and 8 million people with disabilities, and reaching more than an estimated $500 billion in payments in 2010. Although Medicare is a national program, it adjusts fee-for-service payments according to the geographic location of a practice. While there is widespread agreement about the importance of providing accurate payments to providers, there is disagreement about how best to adjust payment based on geographic location. At the request of Congress and the Department of Health and Human Services (HHS), the Institute of Medicine (IOM) examined ways to improve the accuracy of data sources and methods used for making the geographic adjustments to payments. The IOM recommends an integrated approach that includes moving to a single source of wage and benefits data; changing to one set of payment areas; and expanding the range of occupations included in the index calculations. The first of two reports, Geographic Adjustment in Medicare Payment: Phase I: Improving Accuracy, assesses existing practices in regards to accuracy, criteria consistency, evidence for adjustment, sound rationale, transparency, and separate policy adjustments to reform the current payment system. Adopting the recommendations outlined in this report will mean a change in the way that the indexes are calculated, and will require a combination of legislative, rule-making, and administrative actions, as well as a period of public comment. Geographic Adjustment in Medicare Payment will inform the work of government agencies such as HHS, the Centers for Medicare and Medicaid Services, congressional members and staff, the health care industry, national professional organizations and state medical and nursing societies, and Medicare advocacy groups.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 246
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Book Description
The Medicare system adjusts fee-for-service payments to hospitals and practitioners according to the geographic location in which providers practice, recognizing that certain costs beyond providers' control vary between metropolitan and nonmetropolitan areas and also differ by region. The fundamental rationale for geographic adjustment is to create a payment structure that adjusts payments for input price differences that health care professionals and institutions face, such as the cost of employee compensation. Medicare provides health care coverage for 47 million Americans, including 39 million individuals who are 65 years of age and older and 8 million nonelderly people with permanent disabilities or end-stage renal disease. The Congressional Budget Office estimates that Medicare payments in 2010 will reach more than $500 billion. Total per capita Medicare spending is not evenly distributed across the country, and the proportion of beneficiaries living in metropolitan and nonmetropolitan areas also varies from state to state. Because Medicare is a national program, policy makers and researchers working to develop and implement its payment systems have long recognized the need to adjust payment amounts to reflect input price differences across geographic areas of the United States.
Author:
Publisher: DIANE Publishing
ISBN: 1428931546
Category :
Languages : en
Pages : 54
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Book Description
Author: United States Accounting Office (GAO)
Publisher: Createspace Independent Publishing Platform
ISBN: 9781720394419
Category :
Languages : en
Pages : 34
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Book Description
Medicare Physician Payment: Geographic Adjusters Appropriate But Could Be Improved With New Data
Author: United States Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781976382727
Category :
Languages : en
Pages : 84
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Book Description
The Centers for Medicare & Medicaid Services (CMS) adjusts Medicare physician fees for geographic differences in the costs of operating a medical practice. CMS uses 89 physician payment localities among which fees are adjusted. Concerns have been raised that the boundaries of some payment localities do not accurately address variations in physicians' costs. GAO was asked to examine how CMS has revised the localities; the extent to which they accurately reflect variations in physicians' costs; and alternative approaches to constructing the localities. To do so, GAO reviewed selected Federal Register documents; compared data on the costs physicians incur in different areas with the Medicare geographic adjustment; and used the physician cost data to construct and evaluate alternative approaches.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
