The most costly Medicare beneficiaries tend to include those who have multiple chronic conditions, those using inpatient hospital services, those who are dually eligible for Medicare and Medicaid, and those who are in the last year of life, says a recently released report by the Medicare Payment Advisory Commission (MedPAC).
MedPAC's June 2011 Data Book contains information on national health care and Medicare spending as well as Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care in the Medicare program, and Medicare beneficiary and other payer liability. The Data Book also examines provider settings and presents data on Medicare spending, beneficiaries’ access to care in the setting (measured by the number of beneficiaries using the service, number of providers, volume of services, or length of stay, or through direct surveys) and the sector’s Medicare profit margins, if applicable. In addition, it covers the Medicare Advantage program and prescription drug coverage for Medicare beneficiaries, including Part D.
None of this info seems particularly new or illuminating. With this recently released report, you would think that APTA should have a strenghtened case for the work that we do (and the need to be compensated for it)in "out patient" settings. We clearly are part of, and have always been a cost saver to the system. So why did we have to incur the MPPR this year and why are "we" always part of the conversation when payment reduction to providers is discussed and determined? The PAC of APTA needs to use this data to strengthen our position in the health care system, as clinicians, and stop talking to us about how to add "cash paying" services to our practices. We are clinicians, after all!
Posted by James Cardone
on 8/2/2011 4:38 PM