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Sunday, September 16, 2012

Health Care Reform Articles -September 17, 2012


Challenged on Medicare, G.O.P. Loses Ground




ORLANDO, Fla. — Maria Rubin is one of the coveted independent voters in this swing state — so independent that she will not say whether she is voting for President Obama or Mitt Romney. She does share her age (63) and, more quickly, her opinion on Medicare: “I’m not in favor of changing it, or eliminating it.”
Her attitude speaks directly to one of the biggest challenges facing the Republican ticket this year: countering the Democrats’ longstanding advantage as the party more trusted to deal with Medicare.
In the 2010 Congressional races, successful Republicans believed that they had finally found a way to do that, by linking the program’s future to Mr. Obama’s unpopular health insurance overhaul and accusing Democrats of cutting Medicare to pay for it. This summer Mr. Romney resumed the offensive, eventually joined by his running mate, Representative Paul D. Ryan.
Initially, polls suggested that the Republican strategy was working. Democrats fretted that Mr. Romney would win the retiree-heavy Florida and increase his support nationwide among older voters, who lean Republican anyway. David Winston, a Republican pollster, wrote a month ago of “a structural shift in the issue” that left the parties in “a dead heat” and Mr. Obama unable to mount an effective response.
But in recent weeks Mr. Obama and his campaign have hit back hard, and enlisted former President Bill Clinton as well, to make the case that the Romney-Ryan approach to Medicare would leave older Americans vulnerable to rising health care costs. Now their counterattack seems to be paying off.


Doctors, others billing Medicare at higher rates

By Fred Schulte, Joe Eaton and David Donald | Center for Public Integrity, Published: September 15


Thousands of doctors and other medical professionals have billed Medicare for increasingly complicated and costly treatments over the past decade, adding $11 billion or more to their fees — and signaling a possible rise in medical billing abuse, according to an investigation by the Center for Public Integrity.
Between 2001 and 2010, doctors increasingly moved to higher-paying codes for billing Medicare for office visits while cutting back on lower-paying ones, according to a year-long examination of about 362 million claims. In 2001, the two highest codes were listed on about 25 percent of the doctor-visit claims; in 2010, they were on 40 percent.
Similarly, hospitals sharply stepped up the use of the highest codes for emergency room visits while cutting back on the lowest codes.
Medical groups say the shift to higher codes reflects the fact that seniors have gotten older and sicker, requiring more complex care. “I rarely have a person who comes to me for a cold,” said Brantley B. Pace, who has practiced family medicine for more than a half-century in Monticello, Miss., and whose bills were among the highest in the sample of claims.
Although patients at individual practices such as Pace’s may be older and sicker, many health-care experts say the age and health of Medicare beneficiaries as a group has not changed, and research supports that contention.
The Center for Public Integrity’s analysis shows no increase in the average age of patients during the decade. Medicare billing data do not indicate that patients are getting more infirm, as their reasons for visiting their doctors were essentially unchanged over time. And annual surveys by the federal Centers for Disease Control and Prevention have found little increase in the amount of time physicians spend with patients.
That suggests that at least part of the shift to higher codes is due to “upcoding” — also known as “code creep” — a form of bill-padding in which doctors and others bill Medicare for more expensive services than were actually delivered, according to health experts and the data analysis by the center.
http://www.washingtonpost.com/national/health-science/doctors-others-billing-medicare-at-higher-rates/2012/09/15/27047458-f2fa-11e1-adc6-87dfa8eff430_print.html


Steward hires away top surgeon from Mass. General

Effort to bolster hospital services

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