Medicare Implements New Payment Rules For Hip And Knee Replacements In 67 Cities
The move seeks to get hospitals to better coordinate care with doctors and rehab centers by making the hospitals accountable for the costs of the operation and follow-up services for 90 days.
The Wall Street Journal:
Hospitals Brace For New Medicare Payment Rules
Starting Friday , nearly 800 U.S. hospitals face sweeping new payment rules that could have a direct impact on their bottom line, but not everyone is ready, industry experts say. The rules will hold hospitals accountable for all the costs of hip and knee replacements for 90 days. If patients recover and go home quickly, hospitals could reap savings. If they have complications or need lengthy stays in a rehab facility, hospitals could owe Medicare instead, starting next year. (Beck, 3/31)
The Associated Press:
Medicare Opens New Push On Hip, Knee Replacement
From Akron to Tampa Bay, from New York City to San Francisco, Medicare on Friday launches an ambitious experiment changing how it pays for hip and knee replacements in an effort to raise quality and lower costs. The idea is to follow patients more closely to smooth their recovery and head off unwanted complications that increase costs. Hip and knee replacements are the most common inpatient surgery for beneficiaries, and Medicare will be using financial rewards and penalties to foster coordination among hospitals, doctors, and rehab centers. Improved care should also reduce costs, the government says. (Alonso-Zaldivar, 3/31)
Toledo Blade:
Medicare Alters Payment Plan For Joint Replacement
The Toledo Metropolitan Statistical Area, which includes Lucas, Wood, and Fulton counties, and 67 other metro areas have a new mandate from Medicare. A five-year pilot program will track joint-replacement surgery patients for three months and combine the costs for surgery and any associated care into a single payment. Federal officials call this a “target price” or “bundled payments.” ... Putting hospitals in the position of managing the patient’s quality of care and costs three months after the surgery has forced closer collaboration between hospitals and local rehabilitation centers, [said Shannon Holley, associate vice president of patient care and operations at ProMedica]. (Harris-Taylor, 4/1)
Lincoln (Neb.) Journal-Star:
Lincoln Among Cities In New Medicare Payment Program
Medicare patients getting hip and knee replacement surgeries at Lincoln hospitals will be part of a new payment program starting Friday. Lincoln is one of 67 metro areas in the U.S. -- and the only one in Nebraska -- where Medicare will debut a new bundled payment program for those surgeries. ... Doctors, hospitals, rehab centers, therapists, home health agencies and other providers will continue to get their regular reimbursements from Medicare. But at the end of the year, hospitals will be held accountable for the total cost of care over the 90-day period. "Everybody's going to get paid the same, but it's just the hospitals taking the risk," said Robb Linafelter, CEO of the Lincoln Surgical Hospital. (Olberding, 3/31)
In other Medicare news —
CQ Healthbeat:
Groups Wary As Medicare Creates Measures For Judging Doctors
Health professional societies and consumer groups have asked Medicare to tread carefully while overhauling its system for paying doctors, raising concerns about an agency suggestion to include guidelines from a campaign that seeks to curb the use of often unneeded procedures and treatments. Medicare officials are awaiting White House clearance of a draft rule designed to tie payments for doctors to judgments about the quality of care they provide. The Office of Management and Budget has been reviewing this proposal since March 25. The Centers for Medicare and Medicaid Services rule would carry out the changes mandated in last year’s congressional overhaul of Medicare physician payments. (Young, 3/31)