Medicare Enacts Major Reimbursement Change For Knee And Hip Replacements
To try to bring down costs and improve quality, payments and rewards will be tied to the results of the surgical procedure. Elsewhere, South Carolina ambulance owners complain that a Medicare experiment requiring patients to obtain prior authorization for non-emergency ambulance transportation is not being administered properly.
The Associated Press:
Medicare Launches Payment Overhaul For Hip, Knee Replacement Surgery
Striving for better quality and more predictable costs, Medicare on Monday launched a major payment change for hip and knee replacements, the most common inpatient surgery for its 55 million beneficiaries. Starting April 1, hospitals in 67 metropolitan areas — from Akron, Ohio, to Wichita, Kansas — will be held responsible for the results of hip and knee replacements. The aim is better coordination that starts with the surgery itself, and continues through recovery and rehabilitation. (Alonso-Zaldivar, 11/16)
The (Charleston, S.C.) Post and Courier:
Medicare Rule Draws Sharp Criticism From Ambulance Industry
Private ambulance company owners in South Carolina have become increasingly critical of a Medicare experiment designed to eliminate insurance fraud and save the federal government money. ... Medicare implemented the new rule in South Carolina almost a year ago. It requires patients to obtain prior authorization before the government pays for routine, non-emergency ambulance transportation. In theory, the rule makes sure only the sickest patients who can’t transport themselves qualify for the expensive service. But ambulance owners have complained that the company designated to administer Medicare in South Carolina seems to approve and deny transportation requests at whim. (Sausser, 11/16)