Medicare payment transparency

The Medicare prospective payment system.

In 1983 Congress adopted the most significant change in the Medicare program since its inception in 1965. Along with measures to ensure the solvency of the Social Security System into the next century, Congress approved a system of prospective payment for hospital inpatient services, whereby hospitals are paid a fixed sum per case according to a schedule of diagnosis related groups (DRGs). The ...

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 ...

Reforming anesthesia payment under Medicare.

Medicare Interim Payment System's Impact on Medicare Home Health Utilization

The Medicare home health interim payment system (IPS) implemented in fiscal year 1998 provided very strong incentives for home health agencies (HHAs) to reduce the number of visits provided to each Medicare user and to avoid those beneficiaries whose Medicare plan of care was likely to exceed the average beneficiary cost limit. We analyzed multiple years of data from the Medicare Current Benefi...

Medicare Payment Models: Past, present, and Future

When Medicare was first implemented in 1966 nearly half of all Americans 65 and older were without health insurance. Fifty years later only 2% lack health insurance. The difference, of course, is Medicare. Medicare now covers 55 million people, about 17% of the U.S. population, and is the single largest purchaser of personal health care. But despite this success the rising costs of health care ...