MedPAC Hints at Bundled Payments for Radiology and Other Services in Hospitals in 2008 Report to Congress
The House Ways and Means Subcommittee on Health heard testimony from the Medicare Payment Advisory Commission (MedPAC) Chair Glenn M. Hackbarth on Tuesday, a week after the Commission submitted its annual report to Congress.
The hearing focused largely on the subject of efficiency and value of services provided to Medicare patients. Private Fee-for-Service Medicare Advantage plans once again came under scrutiny from Subcommittee Chairman Pete Stark, D-Calif., and other members. These plans have been under a microscope for over a year due to the fact that they receive on average a 13 percent higher payment rate than traditional Medicare plans. The higher payments are supported by President Bush and are intended to account for additional benefits given to patients enrolled in the private plans. MedPAC however, contends that the plans are not delivering on their promise to deliver superior benefits in relation to the higher payment rate and has recommended that payments be equalized. Democrats on the panel in large part agree and have proposed to completely eliminate the extra payments to fund other areas of need within the Medicare program such as avoiding a looming 10.6 percent physician payment cut set to go into effect on July 1, 2008.
Bundled payments for imaging and other services was the topic of a question from Rep. Lloyd Doggett, D-Texas. Referring to a pilot program to explore issues related to “bundled” hospital and physician payments for services around a hospitalization, Rep. Doggett stated, “It is my understanding that that would mean there would be a single fee, or set payment, paid to cover the hospital and physician services provided as part of that episode of care. This discussion about bundled payments has caused some consternation within the physician community.” In response, Hackbarth replied that MedPAC has not made an official recommendation regarding bundled payments for radiology, anesthesiology, pathology and other services but indicated that the Commission was likely to recommend in a subsequent report that Medicare take “transitional steps” toward bundled payments for certain episodes of care.
The ACR will continue to keep members informed on the possibility of bundled payments and other Medicare issues of interest to radiology. For further information, please contact ACR’s Senior Director of Government Relations, Josh Cooper, at jcooper@acr.org, or ACR’s Assistant Director of Congressional Affairs, Orrin Marcella, at omarcella@acr.org.