reimbursement rates

Ambulatory care has skyrocketed in recent years; some estimates claim that 60 to 70 percent of all surgical procedures in the US are done on an outpatient basis. Earlier this month, CMS said it would expand the list of procedures approved for patients to receive at ambulatory surgery centers (ASCs). On the downside, CMS also said that it would pay ASCs reimbursement rates similar to those of hospitals. The Business Journal of Milwaukee observes that CMS's proposed changes could …

Congress is unlikely to cut physician reimbursement rates as mandated by a 1997 program designed to decrease Medicare spending. The 1997 program set up annual spending goals for physician reimbursement. If those goals exceeded economic growth, that was supposed to trigger reimbursement cuts because Medicare funding can't keep doctor's repayments in line with rapidly inflating healthcare costs. But lawmakers fear that decreasing doctors' pay will drive beneficiaries from the program and …

A long-running concern of Congress, analysts and physician groups is that decreased Medicare reimbursements will prevent physicians from accepting Medicare beneficiaries. The concern came to the forefront in 2002 when fees were reduced by 5.4 percent and have continued as healthcare costs outpace reimbursement rates.

Now a GAO report finds that reimbursement has little impact on beneficiaries' access to doctors. The report asked beneficiaries whether or not they had difficulty …

Look out! If and when Medicare changes come, your institution may be hit hard.  That's the conclusion drawn by many providers, who fear that the proposed reimbursement changes will prove to be far more than a "shift" in funds. Theoretically, providers as a group won't actually lose money. The plan would simply reallocate the $125 billion a year that Medicare pays to hospitals and attempt to cut out biases and distortions that make some patients profitable and others not. But there's …

Landmark Medical Center of Woonsocket, RI is claiming that the state's largest insurer, Blue Cross Blue Shield, owes the hospital $4.5 million in unpaid reimbursement rates. After years of wrangling with the insurer, yesterday Landmark's board of directors voted to allow hospital president Gary Gaube to take the necessary steps to receive the reimbursements, including filing a lawsuit if needed. Landmark also wants higher future reimbursement rates, totaling an additional $4.5 million. A …

> Newly elected AMA president William Plested shares his thoughts the future of hospital technology, his views on nationalized healthcare and predicts the role healthcare will play in the next presidential election. Not surprisingly, he argues that doctors and patients should have more say in the functioning of the healthcare system: "[I]t's the physicians and the patients that must design a system. We can't have politicians or insurance companies doing it." …

The number of physicians making house calls appears to be rising steadily again after years of decline. NPR looks at the factors involved in the trend, which is up by 40 percent since 1998 when Medicare raised reimbursement rates for home visits by almost 50 percent. Changing attitudes toward disease management have played a role, as have technological advances which have given physicians the ability to take their practices on the road. Armed with a laptop and a basic Internet …

In previous years the American Medical Association has been able to stave off cuts in physician reimbursement rates by lobbying Congress. This year, however, things appear to be playing out a little differently. Fiscal pressures in Washington are making a compromise a lot less likely, according to observers. For its part the AMA is warning that the scheduled 4.4 percent cut in Medicare Part B reimbursement to physicians could lead to a strong reaction. The physician's lobby released a …

The suspicious June trades which led to a formal SEC inquiry into possible rules violations at HCA are part of a pattern at the company, some analysts say. HCA insiders have always had a knack for good timing and understanding "when their company's stock is undervalued and when it isn't." In the late 1990s, executives at the company sold heavily as the value of the company's shares rose, notes insider trading expert Michael Painchaud. It happened again in 2001 and 2002.

The …

As expected, the Centers for Medicare and Medicaid Services announced an increase in the premium senior citizens will pay for their health care benefits. The basic premium will rise 13 percent to $88.50 a month. The combined premium, including the prescription drug benefit scheduled to go into effect in January, will average $132 a month.

The seemingly modest $10-a-month increase is in reality a political hot potato. It's drawing attention both to massive variation in Medicare …