Hospitals, Manufacturers Resist Forthcoming Medicare Payment Changes
As Hospital Buyer covered last month, Medicare plans to base its payment rates on costs rather than what hospitals charge for procedures starting next year. We reported significant resistance from manufacturers who fear innovation might be slowed down by the new reimbursement rules. The New York Times cites several hospital executives who have concerns too. Dr. Alan D. Guerci, president of St. Francis Hospital in Roslyn, N.Y., was quoted as saying: “It will significantly reduce payments for cardiac care and will force many hospitals to reduce the number of cardiac procedures they perform.” According to the NYT, device makers are to meet with White House officials this week while more than 200 members of Congress have signed letters supporting a one-year delay.
Several patient organizations wrote in a letter to the administration that the new system “could have a devastating impact on payment for critical treatments for seriously ill patients, with reimbursement for some essential procedures cut as much as 30 percent.” The Women’s Health Research expressed concern last month that “the proposed changes to the payment system could reduce women’s access to the best and most appropriate care, because many of the diagnostics, devices and treatments designed for women are among the newest developments.” Peter L. Ashkenaz, a spokesman for the Medicare agency, would not comment before the regulation was finalized. Medicare pays more than $125 billion a year to almost 5,000 hospitals.
Some members of Congress have also expressed reservations about the sole source contract awarded to 3M Health Information Systems (HIS) in May 2005 to analyze whether it was feasible for Medicare to use a payment system modeled on an existing 3M product. 3M HIS has been the DRG (Diagnosis Related Group) maintenance contractor for CMS since the start of Medicare’s prospective payment system in 1983,
July 18, 2006 Related topics: Finance, IT & software