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US Advisers Urge Broad Medicare Payment Reform
By Susan Heavey, Reuters
February 27, 2009
The U.S. Medicare insurance program must make widespread changes to reduce costs and shore up payments in order to sustain the program, which covers roughly 44 million elderly and disabled Americans, a U.S. advisory panel said on Friday.
The Medicare Payment Advisory Commission, or MedPac, recommended significant cuts to home healthcare companies, reducing payments by 5.5 percent in 2010. It also called for reining in high reimbursement rates for expensive medical imaging services and reforming payments for end-of-life hospice care, among other measures.
Such cost control measures are necessary to help maintain the Medicare program amid rising federal budget shortfalls and an aging population, it said.
The U.S. Centers for Medicare and Medicaid Services (CMS) oversees the Medicare insurance program.
"With each passing year, the Commission's concern about Medicare's long-term sustainability intensifies. To slow the growth in Medicare expenditures, we have concluded that the Congress and CMS will need to make changes across a broad front," the commission wrote in its annual report.
Home healthcare providers, which dispatch nurses, therapists and other specialists to patients' homes to help care for them after an illness, accident or surgery, include Gentiva Health Services Inc (GTIV.O: Quote, Profile, Research) and Amedisys Inc (AMED.O: Quote, Profile, Research), among others.
Medicare has been overpaying for such services and should close the gap in 2010 and 2011, MedPac said, adding that "efficient providers should be able to absorb increases in the cost of care even at reduced payment levels."
The commission also repeated its call for reduced payments for Medicare Advantage insurance plans, which private insurers offer as an alternative to the government's traditional fee-for-service program.
Despite economic pressures, MedPac did call for rate increases in some areas, most notably a 1.1 percent hike for doctor visits. It also said the rate for dialysis services should rise 1 percent in 2010.
Payments for other sectors, including skilled nursing facilities, long-term care hospitals and inpatient rehabilitation facility services, are currently adequate and should not see changes, it recommended
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