KHN Morning Briefing

Summaries of health policy coverage from major news organizations

MedPAC Contemplates Link Between ACOs and Medigap Plans

The Medicare Payment Advisory Commission is considering whether Medicare should create supplemental Medigap coverage to encourage patients to seek treatment from an accountable care organization.  

Medpage Today: MedPAC Floats Idea Of ACO Medigap Plan
A "Medicare Select ACO supplemental plan" would provide lower cost-sharing for patients in an ACO in an attempt to increase loyalty to that ACO's providers, MedPAC staff told commissioners. A common complaint about ACOs has been that patients are free to receive care from any provider they like and not stay within that ACO, even though ACO providers remain financially responsible for that patient (Pittman, 9/12).

CQ HealthBeat: MedPAC Plans Closer Look At Medicare ACOs
The Medicare Payment Advisory Commission plans to more closely examine Medicare accountable care organizations and at its meeting on Thursday reacted to a potential new way to encourage patients within ACOs to use in-network providers. Within the next few months a contractor for MedPAC will interview some of the participants in Medicare ACOs and report back on those experiences. Currently, the Medicare shared-savings program includes 220 groups of providers and 23 groups are in the Pioneer ACOs (Adams, 9/12).

In other Medicare news -

The Center for Public Integrity: Feds Propose Shakeup For Emergency Room Billing
Federal officials for more than a decade have let hospitals decide on their own how much to charge Medicare for certain emergency room overhead and staffing costs called "facility" fees — a controversial policy some critics believe invites overcharges. Now in a major turnabout, the Centers for Medicare and Medicaid Services are seeking tighter controls over the fees as part of a plan to redirect billions of dollars Medicare spends annually on outpatient health care (Schulte, 9/12).

Earlier, related KHN story: 'Facility Fees' Are Surprise Cost For Many Patients (Boodman, 10/6/2009)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.