On the Varieties of Medicare Expenses…

Good morning, ProviderNation.

Long term, post acute and home health care seems to be the Rosetta Stone of Medicare cost variation, the fine folks at the Institute of Medicine have found.

Regional variations in Medicare spending have long bedeviled researchers and cost-cutting types. IOM crunched the numbers and found that if every region spent the same on long term and post-acute spending, it would eliminate 73 percent of Medicare cost variances.

Kaiser’s Jordan Rau, who had the most thorough write-up of Thursday’s report, has it like this:

“Since Medicare has fixed prices for what it pays, the differences among regions are due to more people being enrolled in certain services, such as home health care; getting care for longer periods; or being channeled into more expensive treatment options, such as going into an inpatient rehabilitation facility.”

Well, sort of: Because Thursday’s report suggests that Congress ought to make docs and hospitals coordinate care better:

“Instead, the panel recommended that Medicare should continue to change the way it pays hospitals and doctors—the groups making health care decisions— so they coordinate their efforts better. The government has been experimenting with a number of alternative models, including giving medical providers a lump sum, known as bundled payments, to care for all of a patient’s needs for a discrete ailment such as a knee replacement. Another Medicare experiment called accountable care organizations takes that notion a step further by paying a fixed sum to doctors and hospitals to care for any issue that arises for a patient. In both experiments, providers would end up pocketing more money if they kept costs low without sacrificing quality.”

That sound you’re hearing is AHCA boss Mark Parkinson, clearing his throat for another chorus of “We Are the Solution…”

Speaking of Parkinson, yesterday he predicted that there might well be another showdown over government spending this fall. And, as if on cue, President Obama and the Democrats are promising that they’ll take “a more confrontational approach…”

Not exactly blood curdling, I know. But in Washington, that kind of talk passes for Peter Finch stuff…

1 Comment

Filed under Long term care

One response to “On the Varieties of Medicare Expenses…

  1. Great post. We covered the same IOM report: http://bit.ly/13KZsAF. Do you think Congress will take the IOM’s advice?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s