MedPAC Supports DRG Overhaul, Though Data Does Not Meet Its Worst Fears
This article was originally published in The Gray Sheet
Executive Summary
A CMS advisory group remains supportive of the Medicare agency's proposed overhaul of the inpatient payment system, despite recent analysis suggesting that the impact of physician-owned specialty hospitals on the U.S. healthcare system has not been as damaging as forecasted
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JAMA Study Links Specialty Hospitals To More Cardiac Interventions
Results of a new study appear to contradict 2005 Medicare Payment Advisory Committee data showing no link between the emergence of cardiac specialty hospitals and an increase in cardiac revascularization procedures
JAMA Study Links Specialty Hospitals To More Cardiac Interventions
Results of a new study appear to contradict 2005 Medicare Payment Advisory Committee data showing no link between the emergence of cardiac specialty hospitals and an increase in cardiac revascularization procedures
Specialty hospitals spared
Updated analysis in the Medicare Payment Advisory Commission's August Report to Congress shows "growth rates of angioplasties and defibrillator implantation when measured separately are not significantly higher in markets with physician-owned cardiac hospitals," and the facilities have no significant effect on the ratio of low- to high-severity cases performed (1"The Gray Sheet" April 24, 2006, p. 6). A moratorium on Medicare enrollment of physician-owned specialty hospitals, in effect since 2003, ended Aug. 8 with CMS' release of its own report to Congress. "We do not believe that a continuation of the suspension is warranted," the report states, and "we are not recommending legislative action at this time" to curtail physician ownership of the facilities. CMS is refining the hospital inpatient and ambulatory surgical center payment systems to prevent skewed practice patterns by reducing incentives for physician owners to self-refer the most profitable patients. Cardiac specialty hospitals will see an aggregate reduction of 5% in their payment weights in 2009 when the new cost-based weights for inpatient payments are fully adopted (2"The Gray Sheet" Aug. 7, 2006, p. 3)...