Reuters: "Medicare's move in 2005 to pay doctors to do bladder cancer surgery in their offices rather than in hospitals dramatically raised the number of procedures and overall health costs, U.S. researchers said on Monday. ... The findings reflect the complexity of cutting health costs in the United States, showing how in some cases Medicare -- the insurance program for the elderly and disabled -- gives doctors incentives to provide too much care, they said." "Bladder cancer is the most expensive of all cancers to treat, with an average cost from diagnosis to death ranging from $96, 000 to $187, 000, according to [Dr. Micah Hemani, a bladder cancer expert] and colleagues.
Health Affairs: Prices Don't Drive Regional Medicare Spending Variations - "Per capita Medicare spending is more than twice as high in New York City and Miami than in places like Salem, Oregon. How much of these differences can be explained by Medicare's paying more to compensate for the higher cost of goods and services in such areas?" After performing a price-adjustment analysis on Medicare spending in 306 Hospital Referral Regions, the authors - most from Dartmouth Institute for Health Policy - found that "utilization - not local price differences - drives Medicare regional payment variations, along with special payments for medical education and care for the poor.
Sen. Mary Landrieu, D-La., won a $300-million Medicaid bonus for her state during health overhaul negotiations, spawning a wave of criticism that Democratic leaders needed to make the so-called "Louisiana purchase" to secure her support for their reform bill. On Thursday, she defended the action, saying during a Senate floor speech, "I make no apologies for leading this effort. I do not back up an inch, " The (New Orleans) Times-Picayune reports. She challenged Republican senators to confront her on the spot Thursday or "keep their mouths shut" (Tilove, 2/4). The remarks came after conservative talk show hosts Glenn Beck and Rush Limbaugh called Landrieu a "prostitute" for cutting the deal, the Associated Press/Washington Post reports.
Lawmakers may include a number of Medicare "fixes" in the jobs bill, now that the health overhaul bill has stalled, The Hill reports. They would include restoring Medicare provisions that expired Jan. 1 or are set to expire later this year. "Nursing homes and rehabilitation therapy providers, along with patient groups, are pushing legislation to undo a hard-dollar cap on Medicare coverage of physical, speech and occupational therapy. Hospitals are seeking to restore special payments to large rural and small urban hospitals. Physicians also are pursuing the reinstatement of bonuses to rural doctors. Doctors are also clamoring for action to prevent a 21 percent cut in their Medicare payments that looms March 1.
A clinic closure in Atlanta has patients and clinic officials struggling to find new providers that will treat low-income patients who need kidney dialysis, The Associated Press reports. "The treatment typically costs $40, 000 to $50, 000 a year, and Grady is just one of the struggling public hospitals cutting the service to reduce costs. Many indigent dialysis patients ... are illegal immigrants, so facilities that give them routine treatments receive no federal money for their care." The clinic closed in October, but patients have been getting private dialysis treatments funded by the clinic - Grady Memorial Hospital. Other hospitals in Miami and Las Vegas are facing similar cuts and dilemmas.
Stalled health care reform efforts have created several unresolved issues, some of which related to Medicare and Medicaid. The Hill: "Medicare beneficiaries face a steep cliff in their coverage for physical therapy and similar treatments due to Congress's failure to enact a healthcare reform bill. On Jan. 1, the clock started ticking for those patients who need physical, occupational or speech therapy, which is now subject to an annual limit on benefits." The pending legislation "included language to block the so-called therapy caps, but with that bill sidelined, beneficiaries and therapy providers are seeking other means to keep the money flowing.