- Joined
- Jul 8, 2008
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Although there were a lot of vague medicare reforms in the new stimulus bill.. one specific reform will def. involve anesthesiologists:
Bundle hospital and physician fees
"When you pay doctors for every procedure they do, there's an incentive for unnecessary treatments. There's a financial reward for fixing problems that better care might have prevented. And there's no incentive for doctors to prevent complications. On the other hand, few people want to go back to capitation — paying a single, annual fee for all of a patient's care. That's been criticized for leading to undertreatment. So a lot of powerful people are looking toward a middle road: Paying a single, bundled fee for an "episode of care" such as a hip implant or a few months of treatment for cancer or a chronic disease."
"The Centers for Medicare & Medicaid Services (CMS) recently announced the 5 sites for its Medicare Acute Care Episode demonstration. The demonstration will include 28 cardiac and 9 orthopedic inpatient surgical services and procedures and CMS will make a single payment for both Medicare Part A and B services."
"So for hip replacement surgery, it's not one fee for the pre-op X-rays, and one fee for the anesthesia, and one fee for the surgery, and one fee for the hospital stay, and a regular set of fees for the rehabilitation process – it's one fee for the entire health care "episode"."
This reform will divide and conquer doctors/hospitals by basically making us all fight for the scrapes of the bundle so insurance companies won't have to.
Any thoughts how this will impact Anesthesia? One thought I had would be surgeons+hospitals might cut us high and dry by solely using CRNAs so that they can each take a bigger chunk. This of course is just a thought...
Bundle hospital and physician fees
"When you pay doctors for every procedure they do, there's an incentive for unnecessary treatments. There's a financial reward for fixing problems that better care might have prevented. And there's no incentive for doctors to prevent complications. On the other hand, few people want to go back to capitation — paying a single, annual fee for all of a patient's care. That's been criticized for leading to undertreatment. So a lot of powerful people are looking toward a middle road: Paying a single, bundled fee for an "episode of care" such as a hip implant or a few months of treatment for cancer or a chronic disease."
"The Centers for Medicare & Medicaid Services (CMS) recently announced the 5 sites for its Medicare Acute Care Episode demonstration. The demonstration will include 28 cardiac and 9 orthopedic inpatient surgical services and procedures and CMS will make a single payment for both Medicare Part A and B services."
"So for hip replacement surgery, it's not one fee for the pre-op X-rays, and one fee for the anesthesia, and one fee for the surgery, and one fee for the hospital stay, and a regular set of fees for the rehabilitation process – it's one fee for the entire health care "episode"."
This reform will divide and conquer doctors/hospitals by basically making us all fight for the scrapes of the bundle so insurance companies won't have to.
Any thoughts how this will impact Anesthesia? One thought I had would be surgeons+hospitals might cut us high and dry by solely using CRNAs so that they can each take a bigger chunk. This of course is just a thought...
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