Hospitals have come out swinging against payment cuts to their industry included in the House Republican plan to stop a scheduled Medicare physician payment cut next January. And the House GOP is swinging right back.
Photo by Sergio Béjar via Flickr
As the House edges toward a vote Tuesday on legislation that would give physicians a two-year reprieve from a scheduled 27 percent payment cut next January, the House Republican Conference released several documents Monday detailing why they included hospital payment cuts as part of its plan to finance the “doc fix.”
Hospitals would finance about $17 billion of the $38 billion price tag and are none too happy about it. The cuts would include lower Medicare payments for the patient share of bills that providers – including hospitals and nursing homes — aren’t able or are unwilling to collect, starting in 2013, and reduced Medicaid disproportionate share payments beginning in fiscal 2021. Hospitals are also steamed about the potential for lower payments for evaluation and management office visit services.
“These potential cuts would be devastating to hospitals and the patients and communities they care for, especially at a time when hospitals are already absorbing cuts as a result of state reductions and recent legislative and regulatory changes, including the recently enacted 2 percent cut under sequestration,” American Hospital Association President and CEO Rich Umbdenstock said Dec. 9.
Documents prepared by the House Ways and Means majority staff and circulated by the House Republican Conference take issue with those claims. Quoting the Health and Human Services Office of Inspector General, the documents say that because Medicare would pay most of the patient “bad debts,” there was little incentive for hospitals to collect unpaid deductibles and coinsurance. They also note that Medicare now pays more for evaluation and management services performed in hospital outpatient departments than it does for the same services performed in physicians’ offices.
In a separate statement, House Ways and Means Republicans noted late Monday that the hospital provisions would reduce Medicare spending by 0.5 percent over the next decade — “hardly a ‘major reduction.’” The release also notes that hospitals agreed to $155 billion in hospital Medicare cuts included in the health care law. Hospital groups have said they backed the cuts as part of the law’s larger goal to provide health coverage to millions of uninsured Americans.
In documents sent to the Hill Tuesday, the AHA said its members do make a reasonable effort to collect unpaid deductibles and coinsurance, but add that many Medicare beneficiaries have modest incomes, which make those payments difficult. In 2006, the AHA notes, almost two-thirds of Medicare beneficiaries had incomes of less than $30,000. The AHA also says that hospitals should be paid more for outpatient evaluation and management services because hospitals have higher operating costs – for example they run emergency departments — and higher regulatory costs.
While the House bill, which includes an extension of the current Social Security payroll tax cut, is expected to pass that chamber, analysts say it is dead on arrival in the Senate, because Democrats there will oppose several provisions, including one that would speed construction of the Keystone XL pipeline. Democrats will also oppose other provisions, including the House bill’s cuts to the health law’s prevention fund and its plan to have higher-income Medicare beneficiaries pay more for their coverage.
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RE: Hospitals Clash With House Republicans On Medicare Cuts
Anybody surprised? I’m not! I always knew that logic would eventually enter into the thinking of hospital groups and that they would realize that common sense is not normally a Republican characteristic. You see, today’s typical Republican is at odds with most normal common sense thinking. Most of their thinking is politically motivated and that, in and of itself, is not common sense thinking. Ending Medicare is a Republican plank. Every American voter needs to know that when they go to the polls to vote in 2012. Republicans also want to end Social Security. Voters need to decide if these two programs are good or bad and then make sure they vote.
Cutting medical spending is not the way to go. Maybe we should start cutting Politician’s salaries instead?
Dr. Donald Berwick, who oversaw Medicare and Medicaid until earlier this month, has it 100 percent correct when he says America’s health care delivery system is broken. Berwick says health care delivery in America is fragmented, unsafe, not patient-centered, full of waste and unreliable. Republicans like it that way! Republicans like chaos! Chaos means consumers will spend their precious dollars needlessly on an inefficient health care delivery system and Republicans have always liked that. That is why Republicans want to repeal Obamacare. Obamacare is a threat to the current inefficient health care delivery system. A system that makes huge profits for corporations at the expense of consumers. That is the Republican way!
Sarah’s response is either a gross lack of knowing the facts, or a diliberate attempt to keep polarization alive. She said the Republicans want to kill Medicare and Social Security, which are both out-right lies and myths paraded every day to avoid taking time to learn the real facts. . Obama Care – has already cut $500 Billion from Medicare in its legislation. Is that the Democrats taking good care of the seniors? And that is a fact. the Democrats want to sweep under the carpet. The out and out misleading statements will continue through the elections. Then with Obama out of office – we can put his health care plan out also, and go to a more sane approach to getting health care costs under control.
Multiple studies have demonstrated spending more money on health care in the US does not result in better care. Rather than discussing how much money is spent/or taken from programming is meaningless. What matters is patient outcomes, and President Obama’s health care reform – all be it not perfect – attempts to address “system” problems that will save money and lead to better outcomes for patients. Until people realise spendng more doesn’t result in better care, we will all continue to ride in the health care hamster wheel – round and round we go, always stopping where we started and starting where we stopped!
Yes, no question about it Brad, “multiple studies” have indeed demonstrated as you suggest. But, just as many studies, if not more, have suggested the opposite too. Any political party can hire a think tank to rule in their favor. Both Republicans and Democrats do it constantly. Americans are basically sheep and they routinely believe lies. I suggest that blog readers here not be so naive as to simply believe your words just because you try to sound like an authority by suggesting the studies you point to have any special credence. Like lobby groups and lawyers, they are paid to think exactly like the people paying them.
Rich, since you seem to indicate you are immune from research bias, what do you suggest the United States do to improve healthcare and reduce costs. I suggest we focus less on money and more on pt. outcomes. I just saw a patient in my clinic today who had $10,000 worth of services provided for low back pain without change – a poor outcome. Do you believe if we spend more money on this case we will improve his outcome, or is this issue indpendent of money? A fee for servcie system, with more money paid for doing more vs. providing the right care is not likely to remain sustainable.
Regarding me being immune from research bias, what gives you that idea? My post simply confirms the age old adage about “opinions” and who has them. I believe the proverb refers to a part of the anatomy that is included in the field of proctology? Opinions mean nothing to me! Regarding fee-for-service medicine (FFS). The FFS model rewards sickness and has never worked for consumers in any way. FFS medicine only works for providers, insurers and drug companies. Consumers have always been abused under the FFS model. That is why most of the other industrialized countries in the world abandoned the FFS model long ago. Only morons would suggest that the FFS model works.
A major step toward sustaining health care in America? Immediately adopt a single-payer universal system like most other industrialized countries have.
Would quality suffer? Probably, since “high end designer” health care would be reduced and more neighborhood community health centers and ACOs would come be created.
Would costs be slowed if insurance companies were completely out of the picture? Absolutely!
Under a single-payer universal health care system, would we still have over 75 million Americans (1/4th of our population) either uninsured or underinsured? Probably not.
Rich, we may not have the exact same opinions on the details, but I absolutely agree with you on the end-game, and I wish more would, that a single payer system is a proper choice.