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Medicare’s prospects are looking up. In their 2013 report, Medicare trustees projected two additional years to the trust fund’s solvency until it runs out of money in 2026. That’s a little like saying the Titanic will hit the iceberg a couple of miles closer to Newfoundland.
Private health insurers want to dump fee-for-service payments systems. The only thing holding them back is the lack of technology in exchanging information with doctors.
Image created by RRY Publications, LLC / Source: Wikimedia Commons and Rico Shen
As if orthopedic device sale reps don’t have enough to worry about, Wright Medical’s CEO, Robert Palmisano announced on April 30, that the company would now be marketing and selling their orthopedic devices directly to the hospital’s paymasters. Read the details here.
Improving federal government finances may open a brief window to overhaul Medicare’s flawed physician payment system. In the midst of rising government revenue from tax collections and bailout paybacks shrinking the federal deficit faster than expected, the Democrat chair and Republican leader of the Senate Finance Committee, Max Baucus and Orrin Hatch, sent letters to…
The nation’s health care piggy bank is looking a little better. Health care spending growth slowed in the U.S. by more than $500 billion between 2003 and 2012. If trends continue for the next decade, current projections of spending may be too high by $770 billion.
On May 8, 2013, the Department of Health and Human Services (HHS) released data showing significant variation across the country and within communities in what hospitals charge for common inpatient services, including orthopedic services.
Source: DHHS
Three aspects of CMS’ proposed payment system stand out to us. First orthopedics did ok, not great, but ok. Second the quality police are coming and 25% of all hospitals can expect to be penalized. And finally, the definition of “inpatient” is being tweaked. Oh, oh.
Is the PILD procedure for LSS (percutaneous image-guided lumbar decompression for lumbar spinal stenosis) reasonable and necessary? The Centers for Medicare and Medicaid Services (CMS) want you to tell them. The agency initiated a national coverage analysis (NCA) of PILD for LSS on April 5, 2013. There is a 30-day public comment period. CMS is…
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Physicians, device makers, hospitals and insurers are all spending big bucks in Washington to influence where healthcare dollars are spent in the next federal budget. Money buys influence. Who is spending the most and getting results? We looked at the numbers.
On April 9, 2013, the biggest insurer in the U.S. and a large chain of hospitals announced they are teaming up to figure out if they’re getting their money’s worth from manufacturers of medical devices. Mark West, president of the joint venture called SharedClarity, reportedly said one might call this the first stages of medical…
The cumulative benefit to U.S. volume surgical procedures due to Obamacare will increase 3.6% by 2022 and will likely offset the 2.3% medical device tax under the new healthcare law. That’s not the political rhetoric of a partisan political pundit, but the result of a new analysis from one of Wall Street’s top orthopedic analysts, Larry Biegelsen of Wells Fargo Securities. And we don’t think Larry was kidding, even though he announced the new analysis on April 1, 2013.
Device manufacturers got a false alarm in mid-March when the U.S. Senate voted overwhelmingly to repeal the 2.3% medical device tax. Unfortunately, the vote was meaningless, as the measure was part of a Democratic spending bill that has no chance of passing the Republican-controlled House of Representatives. The byzantine rules of order of Congress don’t…
On March 28, 2013, the Centers for Medicare and Medicaid Services (CMS) published the latest directive on mandatory payment reductions in the Medicare FFS program under “Sequestration.” As required by law, President Obama issued a sequestration order on March 1, 2013 requiring across-the-board reductions in federal spending.
How much do spinal implants—the screws, plates and cages used in spinal surgery—cost a hospital? A study, presented at the recent AAOS conference and reported on by Nancy Walsh, staff writer for MedPage Today, found wide differences in what hospitals paid for similar devices. In their study Samuel Bederman, M.D., Ph.D., and Sohrab Pahlavan, M.D.,…
“Carpal tunnel injury claims are among the most expensive work injury claims in California with higher than average indemnity and medical payments,” reports a study by the California Workers’ Compensation Institute. Researchers analyzed California compensation claims beginning with year 2001 and found that though carpal tunnel syndrome accounts for less than 1% of the work-related…
Investors of medical device companies may be greeting the automatic budget cuts of sequestration with a big yawn and the White House is accused of fear mongering by Republicans, but Steve Ubl, the head of AdvaMed, the Advanced Medical Technology Association, is worried. In a March 2, 1013 interview with Minnesota’s Star Tribune, Ubl said…
March has arrived and Congress hasn’t passed an alternative deficit-reduction package. That means Medicare provider payments began being cut by 2% on March 1, 2013 as required by the Budget Control Act of 2011 (Sequestration). The health care industry will be impacted by government program spending reductions of $3 billion in the current fiscal year,…
Now that the first $97 million of the new device tax has been collected by the government, it raises the questions of who is paying the price of the 2.3% tax. We’ve seen numerous reports that thousands of laid-off workers from device companies have paid for the tax with their jobs. Other reports from device…
The government’s take on the first bi-monthly payment of the medical device tax came in at about $97 million. That’s the report from AdvaMed on Tuesday, January 29, 2013. Will orthopedic device makers make up the cost in higher sales? Wells Fargo’s analyst Larry Biegelsen recently took a crack at answering that question and concluded…
Image created by RRY Publications, LLC. Source: Wikimedia Commons and RRY Publications
Everybody’s heard about the “Doc Fix”, tax increases and Medicare’s spending cut delays passed by Congress to avoid the “Fiscal Cliff.” But buried in the legislation are 5 laws that you may not have heard about. And they could change your practice.
Congress passed a one-year “doc fix” on New Year’s Day. The President is expected to sign the legislation immediately. The House of Representatives, by a vote of 257 to 167, approved the Senate’s package to put off a 26.5% Medicare physician pay cut by cutting billions from other Medicare providers, including hospitals, pharmacies and dialysis…
The Centers for Medicare and Medicaid Services (CMS) has announced tentative plans on how to handle 2013 Medicare claims in the absence of Congress providing a “doc fix.” “Given the current progress with the legislation, CMS must take steps to implement the negative update,” stated a recent CMS update. Under current law, physicians will receive…
Source: Wikimedia Commons and Crazypaco
Why would Pennsylvania’s leading insurance company want to put a venerable hospital system into bankruptcy? Because they can. And when the CEO of that hospital system balked at the idea, the insurer allegedly said; “You report to me, and you do what I tell you!” Surprised? Amazed? Don’t be. This could be only the beginning.
The Internal Revenue Service (IRS) has published final regulations on the medical device excise tax that will begin after January 1, 2013. In order to pay for coverage for the uninsured, the new health care law provided that any “manufacturer, producer, or importer” of taxable medical devices shall be required to pay a tax equal…
A research team consisting of four Harvard professors, a researcher from the National Committee for Quality Assurance and L. Gregory Pawlson, from the Blue Cross Blue Shield Foundation, found that Medicare Advantage (MA HMO) plans may be offering more efficient patient care than do Medicare Part A and B plans. As reported by Anthony Brino,…
The U.S. Agency for Healthcare Quality and Research (AHRQ) is reopening the debate about the safety and effectiveness of spinal fusion. Their reports are often used by commercial payers in determining coverage policies.
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Orthopedic surgeons should be cheering the new Medicare physician payment plan for 2013. Congress willin’ and the “fiscal cliff” don’t rise, orthopedic surgeons have every opportunity to take advantage of new payment rules that reward keeping patients moving. Read what our payment experts had to say about the new rule.
A GAO study says physicians increase imaging services after they gain ownership in those services. It allegedly cost taxpayers an extra $109 million in 2010. Read about the study here.
How do health care costs in the U.S. compare to those in other developed nations? Americans believe that they have “the best health care in the world” and spend $8,233 per person per year to back up that boast.
Source: Wikimedia Commons and DonkeyHotey
Mitt Romney and Republicans have promised to repeal Obamacare if voters give them the chance in November. What will health care reform look like after the elections if they win? Read what health care marketplace expert Robert Laszewski says you need to know.
