Giving Compass’ Take:
• According to a new RAND Corporation analysis, Medicare appears to be overpaying surgeons for many medical procedures.
• What are policymakers doing to address this issue? How can we call for more collaborative support?
• What does Medicare for all really mean? Click here to find out.
Writing in the New England Journal of Medicine, Andrew Mulcahy and colleagues suggest that federal officials should incorporate ways to more objectively measure the amount of postoperative care surgeons provide to patients—the patient care item that is at the center of the dispute.
Information that Medicare began collecting in 2017 from a sample of the nation’s surgeons suggests that they provide only a small share of the postoperative care that is built into the payments they receive from Medicare.
Modeling done by Mulcahy and his colleagues suggests that if Medicare payments were adjusted to remove the money allocated for the undelivered postoperative care, reimbursements for the procedures in question would be reduced by 28% or about $2.6 billion in 2018.
“There is a growing body of evidence that suggests that Medicare pays surgeons for postoperative care they mostly do not provide,” said Mulcahy, lead author of the perspective and a senior policy researcher at RAND, a nonprofit research organization. “Medicare should adjust payments to reflect the care actually provided.”
Because Medicare caps how much it spends on physicians and related care each year, overpayments to surgeons for procedures results in lower payment rates for other services like office visits. Mulcahy and his colleagues modeled that lower payments for procedures would result in a net increase in payments to primary care providers.
Read the full article about Medicare payments by Andrew Mulcahy at RAND Corporation.
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