"Health & Medical News"

Washington — Medicare’s first run at incorporating chronic care management techniques into the program is closing at the end of this year, with most observers already describing the effort as a false start.

The Centers for Medicare & Medicaid Services launched the Medicare Health Support pilot project three years ago with high hopes. By hiring eight private disease management firms to set up voluntary chronic care improvement programs for beneficiaries, CMS aimed to improve health care quality while lowering costs. At one point more than 150,000 seniors were enrolled in the programs.

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Washington — Nearly 1,000 physicians convened in Washington, D.C., earlier this month to help lobby lawmakers on Medicare payment reform in the face of a tight timeline and an even tighter budget.

Although the American Medical Association’s National Advocacy Conference covered a range of health policy issues, its main focus was on patching the Medicare payment system that otherwise will cause a 10.6% reduction in doctor pay starting July 1. The event featured congressional speakers and an opportunity for more than 100 physician and medical student attendees to meet with lawmakers following an April 2 rally on Capitol Hill.

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Washington — Medicare is facing a long-term financial meltdown, but health policy experts said Congress is not likely in this election year to take the broad actions needed to keep the program sustainable.

Both the physician and hospital portions of the program are in trouble, according to the 2008 Medicare trustees report, released late last month. Part B, of which spending on physician services constitutes about 30%, does not face insolvency because it automatically is funded by general tax revenues and beneficiary premiums.

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Washington — The push to prevent impending Medicare physician pay cuts is being advanced by a new bill that would block such reductions for 18 months.

The legislation, called the Save Medicare Act of 2008, would continue a 0.5% physician pay update for the last six months of 2008 and would institute a 1.8% update for 2009. Physicians are slated to receive a 10.6% cut starting July 1 and an additional cut of about 5% in 2009.

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From:
Treatment Research Institute
600 Public Ledger Building, 150 S. Independence Mall West
Philadelphia, PA 19106
Tel: (215) 399-0980
http://www.tresearch.org

Paying substance abuse treatment providers for results, not services, may lead to improved quality of care, according to the first published study of a novel performance-based contracting system implemented by the State of Delaware in 2002.

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Washington — Congress’ Medicare advisers recommended a 1.1% physician reimbursement increase for next year and a reduction in payments to Medicare private health plans.

The Medicare Payment Advisory Commission’s annual March report assumes that lawmakers again will act to prevent physician pay cuts triggered by the sustainable growth rate formula. Existing law calls for a 10.6% reduction to take effect July 1 and an additional cut of about 5% in 2009.

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Washington — About one in six eligible physicians and other health professionals participated in a new Medicare quality reporting program during its first five months, according to preliminary figures from the Centers for Medicare & Medicaid Services. About half of them are on track to get up to a 1.5% bonus for their efforts.

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Washington — President Bush’s legislation to slow Medicare spending is heavy on provisions related to doctors — from public quality rankings of physicians in five years to instituting pay-for-performance. But the bill doesn’t address Medicare physician pay cuts due to take effect July 1.

James King, MD, president of the American Academy of Family Physicians, said Medicare pay reform needs to be a higher priority for the administration. “They have to come to terms with how they’re going to pay physicians, where the money is going to come from and [how to] pay toward what they want to accomplish.” The American Medical Association is working to prevent the 10.6% pay cut scheduled to kick in for the last six months of 2008.

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Washington — Ongoing consumer complaints about misleading sales pitches for private Medicare health plans have spurred a powerful Senate committee to scrutinize their marketing practices and prompted calls for legislation. The problems have continued despite Centers for Medicare & Medicaid Services efforts to curb abuses.

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Washington — President Bush’s fiscal 2009 health budget, with steep Medicare spending cuts as a main highlight, sets the stage for a tough fight with Congress in the months ahead.

The proposal, part of a wider $3.1 trillion plan, is just the first step in this year’s health care budget debate. Health care organizations and congressional Democrats have found a lot not to like. Bush proposes reducing Medicare and Medicaid spending anticipated under current law by $196 billion over five years, with hospitals as the main target. The plan would do nothing to prevent Medicare physician payment cuts.

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