Data sheds light on escalating medical costs

Prices for Medicare-covered services have stayed flat in comparison

The prices that hospitals ask customers to pay for a series of common procedures have increased by more than 10 percent between 2011 and 2013 – more than double the rate of inflation, according to new data released recently by Medicare. But the amounts paid by Medicare have stayed flat, according to that data. The hospitals’ rising list prices mainly affect the uninsured and people who use hospitals outside their insurance network.

The 2013 Medicare billing information was part of a large release of data breaking down spending based on hospital procedures, physician specialties and other types of care. It included information about roughly 950,000 doctors and health care practitioners who received $90 billion in Medicare payments.

The data revealed that joint replacement was the most common procedure that Medicare paid for in 2013, accounting for nearly 450,000 inpatient admissions and $6.6 billion in payments. Among physicians, cancer specialists received the largest payments from Medicare, but much of their reimbursements went to cover the cost of the very expensive drugs to treat their patients.

The data also point out that a small cadre of doctors and individual medical providers are consistently the biggest recipients of Medicare dollars. The top 1 percent of billers in 2013 took in 17.5 percent of all payments to individual providers that year. Medicare paid at least 3,900 individual health care providers at least $1 million in 2013.

Stay tuned: Big decisions forthcoming

House conservatives have recently offered their plan for repealing President Obama’s health care legislation and replacing it with tax breaks and other changes. But they are divided over whether to replace the law’s subsidies for lower-earning people should the Supreme Court annul them late in June.

The U.S. Supreme Court reviewed a case brought by conservatives asserting that subsidies the administration is paying to millions of people in more than 30 states are illegal. Conservative activists say the law limited the aid to people in states that create their own insurance marketplaces, not those that use the federal government’s website.

Editor’s note: on Senior Voice press day, the Supreme Court ruled in favor of the Affordable Care Act subsidies and against the challenge.

Meanwhile, on Capitol Hill, the House Ways and Means Committee voted 31-8, including several Democrats, for legislation to repeal the health care law’s Independent Payment Advisory Board, a 15-member independent body that would make recommendations on cuts to the Medicare budget, made famous by then-Republican vice presidential candidate Sarah Palin’s labeling it the government’s “death panel.” Under the law, if Congress didn’t agree with the IPAB’s recommendations, it would have to devise its own plan to cut the Medicare budget by the same amount. However, the idea has been so controversial since it was proposed that no members have ever been appointed to the board and it has never met.

Nonetheless, IPAB repeal and a measure to repeal the medical device tax, which also passed the committee 25-14, are headed for the House floor sometime in June. The medical device tax has strong bipartisan support and is likely to pass the House, but IPAB repeal has little chance to pass in the Senate, so lawmakers may try and separate the proposals in order to get the device tax passed.

Also contributing to this report were: Politico, the New York Times, the Associated Press, the Center for Public Integrity and MedPage Today.

Rendered 07/21/2024 17:34