Changes in Physician Reimbursement by Medicare for Critical Care Services from 1998 to 2008

Medicare physician reimbursement: past, present, and future.

Medicare Payment for Physician Services

INCREASING ATTENTION is being given by public policymakers to alternative ways by which Medicare might pay for physician services. (l-l 3). Among the many approaches under consideration are modifying the existing fee-for-service system; establishing prospectively set rates for bundles of services, such as payment based on diagnosis-related groups; developing uniform fee schedules; paying fixed ...

Cost and Outcomes of Medicare Reimbursement for HMO Preventive Services

Medicare beneficiaries enrolled in a health maintenance organization (HMO) were randomized to a preventive services benefit package for 2 years or to usual care. At 24- and 48-month follow-ups, the treatment group had completed more advance directives, participated in more exercise, and consumed less dietary fat than the control group. Unexpectedly, more deaths occurred in the treatment group. ...

Changes in Medicare reimbursement for hospital-acquired conditions including infections.

As part of the Deficit Reduction Act of 2005, Congress required the Secretary of Health and Human Services (HHS) to identify conditions that (1) are high cost or high volume or both, (2) result in the assignment of a case to a diagnosis-related group that has a higher payment when present as a secondary diagnosis, and (3) could reasonably have been prevented through the application of evidence-...

Medicare coding and reimbursement for clinical laboratory services.

Medicare will continue to increase its efforts to cut spending through aggressive review of claims and the use of new fraud and abuse regulations. Providers must be especially careful to provide correct procedure codes that define precisely what services have been provided and accurate diagnosis codes that link those procedures or tests to an appropriate diagnosis. Medicare reimbursement rules ...