Tag: medicare

The Post-Launch Problem: The Affordable Care Act’s Persistently High Administrative Costs

  • May 27, 2015
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Last year we, and many others, drew attention to the chaotic and costly roll out of the Affordable Care Act’s (ACA) exchanges. The chaos is mostly over (unless King prevails over Burwell), but the costs will linger on. The roughly $6 billion in exchange start-up costs pale in comparison to the ongoing insurance overhead that the ACA has added to our health care system — more than a quarter of a trillion dollars through 2022. Bloated Administrative Costs We calculated these new overhead costs from the official National Health Expenditure Projections for 2012-2022 released by the Centers for Medicare and Medicaid Services (CMS)’ Office of the Actuary in July 2014. The projections included separate tables projecting costs with, and without, the effects of the ACA, allowing calculation of

“Transparency” Will Not Fix Medicare Physician Fees

  • May 23, 2015
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The Government Accountability Office (GAO) has released a report criticizing the way the federal government sets physicians’ fees in Medicare. It concludes that “Better Data and Greater Transparency Could Improve Accuracy.” I doubt it. Note the mind-numbing detail of this process: The government delegates its assumed authority to a group of physicians who comprise the Relative Value Scale Update Committee (RUC). The government “reviewed 1,278 RUC work relative value recommendations for about 1,200 unique (new and existing) services)” in the last four years. The Center for Medicare & Medicaid Services (CMS) is the agency that supervises this mess: CMS’s process for establishing relative values embodies several elements that cast doubt on whether it can ensure accurate Medicare payment rates and a transparent process. First, although CMS officials

Celebrating the Medicare #DocFix

  • April 24, 2015
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Photo credit: David W. Parke II, MD This week, I made a pilgrimage to Washington DC to attend a reception in the White House Rose Garden at the invitation of President Obama. It was a heady moment for this new CEO of the American Geriatrics Society and the Health in Aging Foundation. My 91-year old mother and her friends were quite impressed–going so far as to ask me to put in a good word for older adults. Got that covered, Mom. Putting aside the excitement of seeing the Rose Garden and shaking President Obama’s hand (I admit shaking a President’s hand is really exciting), why was this moment so important for geriatrics health professionals and the older adults they serve? Congress, in a rare bi-partisan, bicameral