Congress Moves to Overhaul Medicare Doctor Payments

By Mary Agnes Carey, Kaiser Health News Staff Writer The bipartisan leadership of three Senate and House committees introduced legislation Feb. 6 to overhaul the way Medicare pays physicians. The package, which does not specify how it would be paid for, would repeal the current system, which sets Medicare physician payment rates through a 1997 formula based on economic growth and known as the “sustainable growth rate” (SGR).  Physicians would receive a 0.5 percent increase for each of the next five years …

6 Things to Watch in Congress

Members of Congress are back in Washington with an agenda full of items important to older Americans. Here’s a rundown: Debt ceiling and federal budget. Two deadlines loom here. The federal government will run out of borrowing authority if Congress doesn’t raise the debt ceiling by Feb. 7. Although Capitol Hill lawmakers negotiated a budget deal in December that set overall spending, they must pass a bill with more specifics by Jan. 15. Each time budget deadlines hit, some lawmakers …

Medicare Lists Best, Worst Hospitals for Hip and Knee Replacements

By Jordan Rau, Senior Correspondent, Kaiser Health News Medicare has begun tracking the outcomes of hip and knee replacement surgeries, identifying 95 hospitals where elderly patients were more likely to suffer significant setbacks. The government also named 97 hospitals where patients tended to have the smoothest recoveries. The analysis, which was released last week, is the latest part of the government’s push to improve quality at the nation’s hospitals instead of simply paying Medicare patients’ bills. Medicare already assesses hospital …

Congress Moves to Overhaul How Medicare Pays Doctors

Capitol Hill lawmakers are showing signs that they could finally revamp how Medicare pays doctors. For the short term, the budget deal approved in the House on Dec. 12 delays for three months a cut of 24 percent in physicians’ reimbursements slated to begin Jan. 1. For the long term, after years of last-minute scrambling to stave off the payment cuts, several key Senate and House committees have approved legislation to repeal the formula that Medicare uses to pay physicians, …

Medicare Could Save Big by Steering Ambulances Away From Hospitals

Medicare could save $560 million or more a year simply by allowing some patients who call 911 for an ambulance to be taken somewhere other than a hospital emergency room. What’s more, the study found, private insurers could save twice that amount by following suit. That’s the conclusion of a new study in Health Affairs, which found that more than a third of Medicare patients who called 911 had a “low-acuity diagnosis” that could have been managed outside the hospital emergency …

Will Court Block Insurers from Dropping Doctors?

By Susan Jaffe, Kaiser Health News In a decision that could have national implications, a federal judge in Connecticut temporarily blocked UnitedHealthcare late Thursday from dropping an estimated 2,200 physicians from its Medicare Advantage plan in that state. While the judge’s decision affects only the physicians in Fairfield and Hartford Counties who brought suit, several other medical groups are considering filing similar actions. “This is very good news from Connecticut,” said Dr. Sam L. Unterricht, president of the Medical Society …