Allowing Americans aged 50 to 64 to buy into Medicare would lower health care premiums for the group. But it would also drive up costs for younger people who buy health insurance on Affordable Care Act exchanges.
Medicare appears to be overpaying surgeons for many medical procedures. Federal officials should incorporate ways to more objectively measure the amount of postoperative care surgeons provide to patients.
Results of the Alpha 2 feasibility test, used to help develop standardized assessment-based data elements to meet the requirements of the Improving Medicare Post-Acute Care Transformation(IMPACT) Act of 2014.
Prior to the ACA, Medicare Advantage (MA) enrollment growth led to small reductions in inpatient for the entire population over age 65. After the ACA, this impact diminished, contrary to the hypothesis that the MA ACA payment would amplify this effect.
This report proposes alternative methodologies for determining the practice expense (PE) component of the Medicare Physician Fee Schedule in order to avoid misvalued payment rates. A main concern is the allocation of indirect practice costs.
Fee-for-service Medicare beneficiaries who received their care at federally qualified health centers had fewer ambulatory visits and more visits to the ED compared to a matched comparison group of beneficiaries who received primary care from another source.
Employers paid 3.5 times what Medicare would have paid for the same hospital outpatient services in Indiana — and 2.1 times the Medicare rate for inpatient care. Price transparency nationwide could help employers become better-informed purchasers of health care and stronger advocates for their employees.
Risk-reduction strategies adopted by Medicare Advantage plans to prevent hospital readmissions have not succeeded in lowering the markedly higher rates of readmission for black patients compared to white patients.
Most of the federally qualified health centers that participated in a program to help them adopt a “medical home” model of advanced primary care were successful in doing so. These changes improved access to primary care, but did not decrease the use of specialty care, acute care services or Medicare expenditures.
Most of the federally qualified health centers that participated in a program to help them adopt a "medical home" model of advanced primary care were successful in doing so. These changes improved access to primary care, but did not decrease the use of specialty care, acute care services or Medicare expenditures.
States participating in Project JOINTS, a six-month quality improvement campaign to reduce infection risk after joint replacement surgery, adhered to three new evidence-based practices significantly more than non-participants.