Medicare

Medicare

Author: United States. Government Accountability Office

Publisher:

Published: 2004

Total Pages: 42

ISBN-13:

DOWNLOAD EBOOK


Medicare: Issues for Manufacturer-Level Bidding for Durable Medical Equipment

Medicare: Issues for Manufacturer-Level Bidding for Durable Medical Equipment

Author: Kathleen M. King

Publisher: DIANE Publishing

Published: 2012-10-19

Total Pages: 29

ISBN-13: 1437988490

DOWNLOAD EBOOK

In 2009, Medicare spent approx. $8.1 billion on durable medical equipment (DME), prosthetics, orthotics, and related supplies for 10.6 million beneficiaries. DME includes items such as wheelchairs, hospital beds, and walkers. Medicare beneficiaries typically obtain DME items from suppliers, who submit claims for payment for these items to Medicare on behalf of beneficiaries. The Centers for Medicare & Medicaid Services (CMS), an agency within the Dept. of Health and Human Services (HHS), has responsibility for administering the Medicare program. Medicare and its beneficiaries -- through their out-of-pocket costs -- have sometimes paid higher than market rates for various medical equipment and supplies. To achieve Medicare savings for DME and to address DME fraud concerns, Congress required CMS to phase in a competitive bidding program (CBP) for DME suppliers in selected competitive bidding areas (CBA). In CBP, suppliers submit bid prices in the amounts they are willing to accept as payment to provide DME items to Medicare beneficiaries. CMS then enters into contracts with select DME suppliers to provide DME items at the prices determined by CBP. In contrast to CBP's supplier-level approach, some health care purchasers use a manufacturer-level approach to buy DME items directly from DME manufacturers to obtain savings by leveraging their purchasing power. CMS has not been required to develop a manufacturer-level approach. This report provides information on health care purchasers that currently use a manufacturer-level approach and on issues that would need to be addressed if CMS implemented such an approach. It describes (1) efforts used by some non- Medicare purchasers to reduce DME spending by contracting with DME manufacturers or using purchasing intermediaries, and (2) issues that CMS might face if required to implement a DME manufacturer-level approach with broad authority to do so. Figures and tables. This is a print on demand report.


Medicare

Medicare

Author: Kathleen M. King

Publisher: DIANE Publishing

Published: 2010-06

Total Pages: 65

ISBN-13: 1437926851

DOWNLOAD EBOOK

In 2007, Medicare spent $8.3 billion for durable medical equipment (DME) and related supplies. To reduce spending, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required that the Centers for Medicare and Medicaid Services (CMS) phase in a competitive bidding program (CBP) for DME and other items. DME suppliers began bidding in round 1 of the CBP in May 2007. After contracts were awarded, the Medicare Improvements for Patients and Providers Act of 2008 was enacted in July 2008. This report examined: (1) the results of CBP round 1; (2) the major challenges CMS had in conducting CBP round 1; and (3) the steps CMS has taken to improve future CBP rounds. Charts and tables.


Medicare

Medicare

Author: United States. Government Accountability Office

Publisher:

Published: 2004

Total Pages: 30

ISBN-13:

DOWNLOAD EBOOK


Medicare Payments for Medical Supplies

Medicare Payments for Medical Supplies

Author: United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies

Publisher:

Published: 2002

Total Pages: 72

ISBN-13:

DOWNLOAD EBOOK


The Healthcare Imperative

The Healthcare Imperative

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2011-01-17

Total Pages: 852

ISBN-13: 0309144337

DOWNLOAD EBOOK

The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.


Competition and the Cost of Medicare's Prescription Drug Program

Competition and the Cost of Medicare's Prescription Drug Program

Author: Anna Cook

Publisher:

Published: 2014-09-03

Total Pages: 48

ISBN-13: 9781457856631

DOWNLOAD EBOOK

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the Medicare Modernization Act, or MMA) substantially expanded the federal Medicare program by creating the prescription drug benefit known as Part D. In FY 2013, Medicare Part D covered 39 million people. The federal government spent $59 billion net of premiums on Part D in that year; after accounting for certain payments from states under the program, the net federal cost was $50 billion, which represented 10% of net federal spending for Medicare. A combination of broader trends in the prescription drug market and lower-than-expected enrollment in Part D has contributed to much lower spending for the program than projected when the MMA became law in 2003. This report examines the federal budgetary cost and competitive design of Medicare Part D and compares Medicare Part D and Medicaid Fee for Service. Figures and tables. This is a print on demand report.