The amazing news buried inside a 283-page Medicare report

[babylonsister]

The amazing news buried inside a 283-page Medicare report

Updated by Sarah Kliff on July 28, 2014, 3:40 p.m. ET


This is arguably the most unexpected piece of news in the new Medicare Trustees report: the government's hospital insurance program might be spending less money to cover more beneficiaries than it did a year ago.

Medicare's hospital insurance program — known to wonks as Medicare Part A — spent $266.8 billion covering 50.3 million people in 2012. In 2013, the the same program spent $266.2 billion to cover 51.9 million people. These figures come from Table II B.1 in the 2012 and 2013 reports.

Medicare's hospital insurance program is gigantic; it spends more money in a given year than the entire state of Wisconsin. In that context, $600 million is not much more than a rounding error. And some senior administration officials I spoke with cautioned against reading too much into these particular figures; receipts for services rendered in 2013, for example, might trickle after the year has ended.

But what's definitely clear — and what's driving this trend — is that Medicare is spending significantly less per person than they did two years ago. And this report expects that trend to continue for another two years going forward.



By 2015, the Medicare Trustees' Report projects that the program will spend less per person on hospital care than it did in 2008. This doesn't happen much in health care: not just slower growth, but the actual dollar amount spent on a given type of care dropping.

more...

http://www.vox.com/2014/7/28/5945197/the-amazing-news-buried-inside-a-283-page-medicare-report?utm_medium=social&utm_source=facebook&utm_campaign=ezraklein&utm_content=monday

[enlightenment]

1. Interesting, but I'll

hold back on "amazing" until they can explain why.

As to why this is happening, that's the big question. There has been an overall slowdown in health care spending, some of which is likely due to the recession: when people have less money to spend, they don't buy as many medical services.

It could be, as the article suggests, that doctors and procedures are becoming more efficient and less costly - or it could be something less salutatory.

Thank you for posting the article and link; it's definitely something to keep an eye on in the near future.

[Liberal_Stalwart71]

8. Preventive care, reduction in reliance on insurance cos as intermediaries!

Also, reductions in fraud, waste, and unnecessary administrative paperwork!

[MaggieD]

10. Actually there is more paperwork than ever

Fraud reductions are good, but waste is ill defined. Currently it's a fairly uneducated "auditor" coming in after the care has been provided and deciding later that you didn't really need it based on reading your medical file.

[JDPriestly]

13. People have shorter hospital stays. Hospice care is more commonly available?

Doctors are strongly encouraged, even penalized, for readmitting patients.

And the new technologies, like MRIs make treatment outcomes more certain.

I'm just guessing based on conversations with a friend who is a doctor.

[packman]

2. I would like to think

that as more people get to see a doctor and get early medical treatment, that catastrophic illnesses can be earlier detected and treated thus avoiding major medical bills. I can see this downward trend continuing as ACA winds up and reaches its full potential.

[IthinkThereforeIAM]

14. Me, too...

... those were my first thoughts when a previous poster was asking for an explanation on just why the amount spent per year by Medicare has decreased.

[BrotherIvan]

3. It could also be home care

which Medicare is encouraging and many independent seniors appreciate. Or it could be that more people are sent to "remedial" centers and that is calculated differently. I would like my insurance copay, which I never use, to help make up the costs. As well as every man, woman and child in this country.

[donco]

4. Another reason

for Medicare for all.

[sheshe2]

5. KnR!

Thanks bsis.

[MaggieD]

6. It's not so amazing

Medicare has been auditing tens of thousands of claims each day and in many cases improperly denying payment on them. The third level of an appeal is an administrative law judge appeal, and they are so backed up they currently have an outstanding caseload of 460 thousand pending appeals. Most providers only bother to appeal to that level if they feel they will win. Historically they are correct. Something like 80% that go to ALJ end up being paid.

http://www.jdsupra.com/legalnews/hospitals-file-lawsuit-over-medicare-alj-99666/

[madfloridian]

7. Not necessarily a good thing.

People may not realize that some seniors in good health are deprived of medical cutting technology treatment because they are old. There may be times to consider all the factors, but it should not be done just because of age.

Also Medicare often refuses to pay for things they should be paying for....and those affected are not in good enough health to fight back effectively.

[MaggieD]

9. Correct

I don't think there is huge problem with seniors being denied care. At least not yet. But Medicare is making it very difficult for the provider to get paid. The two main problems are, a) they have created a lot of hoops to jump through and red tape to "qualify" for care, and b) they have hired people to "audit" medical records that don't seem very skilled and deny a lot of claims improperly.

The good news is that unless the hospital tells the patient ahead of time that Medicare won't pay (which doesn't happen much because Medicare should be paying) the patient isn't financially responsible. The bad news is that eventually it will be harder for Medicare patients to find providers willing to take the risk that some uneducated auditor won't come back later and deny payment.

In many respects Medicare has become very much like commercial insurance - always trying to find a loophole that will keep them from paying the claim.

[aggiesal]

11. Thanks Obama ...

Do I really need the emoticon?

[alfredo]

12. KNR

[Cha]

15. This should be good news for everyone excpept republicons, of course.. mahalo babylonsistah!

[tclambert]

16. Gasp! It must be the death panels!!

Alarm!!! Alarm!!!! The gubmint is killing off seniors to save money on Medicare!!!!!






if you couldn't tell from all the exclamation points!!!!!1!1!!!

[hedgehog]

17. I'm thinking something along those lines, but not in a bad way.

All too often, someone who is dying is placed on a respirator, given liquid nutrition (sometimes via a surgically implanted stomach tube) and even resuscitated under a Code Blue. These are people who will never return home; at best they may shuttle to a nursing home and back to the hospital. The entire "death panel" thing was about paying for doctors' time when they sat down and discussed end-of-life options with their patients. If more people are assertive about declaring that they don't want heroic measures taken when they are dying, and if more families are assertive in following those wishes, then people will die quietly in bed instead of in an ICU hooked up to all kinds of machines. Maybe treatment in an ICU would have given my mother and mother-in-law another week of life, or even several more weeks in a hospital bed too weak to even speak or even open their eyes, but neither of them wanted that. The family followed their stated wishes and refused a respirator and liquid nourishment, allowing them to exit peacefully.

Heroic measures saved my father's life 25 years ago after a massive stroke, and he went on to make a full recovery. All heroic measures would have done for my mother is to extend her dying.

[mother earth]

18. You know what's going to save far, far, far more? Two words...single payer.

Scream it from the rooftops & stop settling for the status quo...better does not beat BEST & lower does not beat the lowest on record which is exactly what we will get when we stop cheerleading and start demanding. Of course costs will be lower this is a darn near depression.

[MannyGoldstein]

19. Aging Baby Boomers are causing the # of "younger" recipients to increase quickly

Which is reducing the average age of recipients, and younger recipients are cheaper.

That's my guess as to what's going on.

[MannyGoldstein]

20. Damn, I'm good! (Or at least lucky once in a while)

Average age is decreasing, leading to fewere admissions per beneficiary:

From page 122: "For 2010-2021, this factor is estimated to be negative, reflecting the influx of beneficiaries aged 65 (and the resulting reduction in the average age of beneficiaries) due to the retirement of the baby boom generation."

[MaggieD]

21. I already told you what's going on...

... in a post above. This is what I do for a living. So all of you can speculate, but the facts are in the thread (with a link).

[HockeyMom]

22. My husband and I balance each other out

We both turned 65 last Fall. My husband has been in ICU with a massive heart attack (Code Blue 3 times) since Sunday. He is still working and has Medicare Part A only, and is still covered by his employer's insurance. What will be the hospital bill for all this? I have no idea but when my daughter gave birth last month, the hospital bill for a 2 day normal L&D was $30,000.

My husband has a lot of health issues and see numerous doctor for years, long before his Medicare kicked in. I have no health issues at all, so I am a Senior who is costing Medicare NOTHING at all.

I suppose you could say that the "me's" on Medicare are the people making their costs go down.