Thread: Federal plan would streamline Medicare

Federal plan would streamline Medicare

By Kelly Kennedy, USA TODAY
Updated 50m ago |

WASHINGTON — Health and Human Services proposed new regulations Thursday that it hopes will reduce Medicare costs and improve care by focusing funds on prevention and quality, rather than the number of times a patient sees a doctor.

Health and Human Services Secretary Kathleen Sebelius wants to put the focus on quality preventive care.

Affordable care organizations could save Medicare $960 million over the next three years, Health and Human Services Secretary Kathleen Sebelius said. She emphasized the need for preventive care, saying that one in five Medicare patients who visit the hospital are back within 30 days, and that one in seven suffer a harmful mistake. An additional 100,000 patients die from infections every year.

"These results are unacceptable," she said.

Under the proposed system, which would begin in 2012, hospitals and other medical facilities serving more than 5,000 Medicare patients could form teams of primary care doctors, nurse practitioners and specialists to coordinate a patient's care. The patient would still be able to choose his or her own doctor, and the system is voluntary. The regulation comes as part of the federal health care law passed last year but is open for public comment before it is finalized this year.

Half of Medicare beneficiaries have more than one chronic condition and often receive care from several doctors, according to Health and Human Services. If doctors don't talk to each other, they can make mistakes in prescribing medications that shouldn't be taken with the patient's other prescriptions, or could administer care or tests the patient has already received.

"It describes what we've been up to for 10 years," said Steve Safyer, president of Montefiore Medical Center in New York City. "It really is what people are moving toward."

TIMELINE: Road to health care legislation
Safyer said coordinated care emphasizes quality and safety, and at his hospital, it means going out to visit elderly patients who live in four-story walk-ups in the Bronx, or making sure patients can get all of their care in one place. One doctor takes charge of each patient's care, while a team nurse coordinates appointments. The care manager makes sure a patient knows what to avoid with his heart-disease medications, as well as calling to ensure a diabetic patient has her blood sugar under control. "From a financial point of view, 80% of our payments are Medicare and Medicaid," he said. "This is the only system, in my mind, that can manage the expense."

The organizations would be eligible for bonuses if they improve the quality of their care and reduce wasteful practices. But there's some risk: The government will create a benchmark that each organization must reach to assess whether it will receive a bonus from the savings created, or repay shared losses. Mike Nugent, co-author of Accountable Care Organizations: Your Guide to Strategy, Design, and Implementation, said there are at least 50 affordable care organization projects being considered across the country. A small number do it because of the shared-savings aspect of the plan, he said, but more do it because they need to cut costs.

"The bigger issue is that (Medicare) reimbursement is not going to increase as it has in the past," he said. In the past, Medicare payments have increased about 3% every year, but now those payments will be capped, and doctors will have to cut costs to keep their services competitive. "Competition pre-empts reform. Competition preempts these regulations."

http://www.usatoday.com/news/washington ... 1_ST_N.htm

First, when has the federal government streamlined ANYTHING?!?
Second, when doctors refuse to see Medicare patients because the program doesn't cover their costs, grandma and grandpa will be unable to get treatment - no treatment = lower costs.

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Originally Posted by ReggieMay

First, when has the federal government streamlined ANYTHING?!?
Second, when doctors refuse to see Medicare patients because the program doesn't cover their costs, grandma and grandpa will be unable to get treatment - no treatment = lower costs.

Medicare has a "Find a Doctor" site.

Physician Compare

What type of provider are you looking for?

Location - ZIP Code or City, State

eg. 10009 or New York, NY


Optional Search Criteria
Gender
No preference
Female
Male

Last Name - Full name or a partial spelling


Medicare Assignment
Do you only want to see providers who accept the Medicare-approved amount as payment in full on all claims? If a provider doesn't accept the Medicare-approved amount as payment in full, their costs may be higher. This means you may pay more.

Yes, only show providers who accept the Medicare-approved amount as payment in full.
No preference

http://www.medicare.gov/find-a-doctor/p ... earch.aspx

All kinds of info about Medicare, from Medicare.gov/ @

http://www.medicare.gov/default.aspx

I tried the Medicare "Find a Doctor" and located 9 doctors within 6 mile of my house who accept the Medicare-approved amount as payment in full.

http://www.medicare.gov/find-a-doctor/p ... earch.aspx

House GOP budget to call for dramatic changes to Medicare, Medicaid

From Dana Bash and Deirdre Walsh, CNN
April 2, 2011 3:26 p.m. EDT

Washington (CNN) -- House Budget Chairman Paul Ryan, R-Wisconsin, will unveil a highly anticipated 2012 Republican budget next week that proposes dramatic changes to political lightning rods -- entitlements.

The plan, to be released Tuesday, calls for a controversial overhaul of Medicare, the health care program for seniors, and imposes deep cuts in Medicaid, which provides health benefits to low-income Americans, according to House Republican sources with knowledge of the proposal.

Starting 10 years from now, in 2021, Americans would no longer enroll in the Medicare program, but instead receive vouchers for private insurance, according to the GOP sources, who stressed anyone 55 or older now would not be affected by the change.

The plan is modeled after one Ryan proposed last year with Alice Rivlin, budget director under President Bill Clinton.

Details of how Ryan's Medicare voucher program would work are still unclear, but the Ryan-Rivlin plan said the amount of the voucher -- a lump sum payment from the government -- would be calculated in part by taking the average federal cost per Medicare enrollee.

The GOP goal in revamping Medicare is to save billions of dollars, since Medicare is a large contributor to the massive federal deficit and debt.

Sources said they did not yet know how much savings Ryan would project by drastically changing the Medicare program.

On Medicaid, Ryan's plan calls for deep cuts, as much as $1 trillion. The program would also fundamentally change -- the federal share of the Medicaid system would become block grants to the states.

CNN is told that the House GOP budget plan does not call for significant change to the Social Security program. Republicans argue that while Social Security is a factor in the nation's fiscal crisis, it doesn't contribute as much to the soaring debt as Medicare.

Two House GOP lawmakers briefed on the proposal told CNN they and others on the House Budget Committee believe it's a mistake not to tackle Social Security.

As for so-called discretionary spending, one of the sources -- who would not speak on the record before the plan is publicly announced -- said Ryan's proposal promises to roll back spending to 2006 levels.

It's unclear how much that would slash, but it is expected to be far more than the roughly $61 billion in spending cuts House Republicans passed in February.

Ryan is expected to give specifics on how much savings the plan would create when it is unveiled Tuesday.

A GOP source said even with the major cuts and changes in Ryan's proposal -- essentially a blueprint that guides spending decisions and does not go to the president for his signature -- it would not bring the budget into balance for many years.

Still, GOP sources briefed on the plan said it would save hundreds of billions of dollars more than the president's proposed 2012 budget, and trillions over the next 10 years.

The budget would also cut the corporate tax rate, but at the same time do away with tax loopholes for corporations.

Ryan's plan also provides for a permanent extension of all the Bush-era tax cuts which, under a compromise with President Barack Obama, were extended last year through 2012.

House Republican leaders have been signaling for some time that they plan dramatic and controversial changes to entitlement programs in order to rein in the budget deficit and debt.

Knowing that the proposed changes will be politically risky and elicit an onslaught of criticism, Ryan, along with Republican Whip Kevin McCarthy, has been holding sessions two or three times a week with House Republicans to try to arm them with facts and figures about the gravity of the debt problem and why it needs to be fixed.

CNN was allowed into one of these meetings last month, and heard Ryan lay out for his GOP colleagues in stark terms what he calls the "tidal wave" of debt the country is facing.

"The Congressional Budget Office has this economic model where they measure the economy going forward, and they are telling us that the entire economy crashes in the year 2037 because their computer simulation can't conceive of any way in which the U.S. economy can continue," Ryan told the GOP group.

"By the time my kids are my age, just those three programs -- Social Security, Medicaid and Medicare --will consume all federal revenues. There will be no room for anything else in the federal budget," Ryan said.

When Ryan proposed a version of his Medicare overhaul idea last year, known as his "road map," Democrats skewered it and tried to use it as a campaign weapon against Republicans across the country.

Obama has often said it is important for Washington to address entitlement spending. But the president has not offered any specific proposals and Republicans suggest he is unwilling to back this rhetorical call with specifics because he wants them -- the Republicans -- to take the first risky steps.

Multiple GOP sources admit the timing of Ryan's 2012 budget proposal is tricky. It will be released in the middle of down-to-the-wire, contentious negotiations with Democrats about a spending measure to keep the government running for the rest of this 2011 fiscal year.

CNN is told GOP leaders considered delaying the release of Ryan's budget until this year's spending differences are resolved.

However, they decided to go ahead with it because they hope showing major cuts and reforms planned for next year will help calm rank-and-file conservatives who are unhappy their leadership is compromising too much on spending cuts now.

http://www.cnn.com/2011/POLITICS/04/02/ ... gletoolbar

Sounds like the GOP wants to kill Medicare
and let all of the old people who can't afford their own private health care just die.