Word: medicaid
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...real. Bush had once hoped to overhaul Social Security, Medicare and Medicaid all at once, saying these entitlement programs would hamstring today's children. Aides say that with Democrats in no mood to help, he will start with Social Security but is not going in with his past no-new-taxes swagger, nor will he insist on private accounts, as he did in 2005, though he wants to wind up with both. An official calls it the "new reality...
...Christi Health System in Kansas, complains that these outfits are competing unfairly against St. Francis and St. Joseph, his two general hospitals in Wichita. And he intends to do something about it. Via Christi provided Kansans with some $30 million in charity care and $33 million in unpaid Medicaid services this year. Conlin says Via Christi can no longer afford those costs if it keeps losing money to the new guys. "We're left with no option," says Conlin, "but to set a limit on how much of this kind of work we're going to do. Only then will...
...losses--and those from treating the uninsured--largely with profits from surgeries. They also hike the prices they charge insurers and employers, who give hospitals a 22% margin, according to researchers at the Lewin Group, a consultancy, helping cover overall losses of 5% or more from Medicare and Medicaid. That comes back to the rest of us as higher insurance premiums, making health care all the more costly to employers...
Physician-owned facilities do less charity care and treat fewer Medicaid patients than community hospitals do, government research shows. And they treat healthier (hence more profitable) patients, or--as in the case of heart hospitals--favor well-remunerated treatments. Not surprisingly, doctors who own a piece of the action are more likely to send patients to their own facilities...
Congress and the Centers for Medicare and Medicaid Services (CMS) have taken steps to rein in imaging. Beginning next year, imaging centers will see payment cuts that the industry and its manufacturing allies--GE, Siemens, Phillips--say will reduce some payments to 20% of the cost of doing them. To level the specialty-hospital playing field, CMS will pay hospitals more for their more complex cases. Similarly it proposes to pay ASCs at 62% the rate of hospital outpatient departments. The industry is asking for 75%. Lobbyists are racing to the scene...