Archive for deficit reduction


How Hospitals Staved Off Threatened Fiscal Cliff Cuts

Hospitals were spared three of the major Medicare cuts they feared most in the fiscal cliff solution – bad debt reimbursement, graduate medical education payments, and outpatient evaluation and management (E&M) fees – through vigorous lobbying of Congress.

As the fiscal cliff deadline drew nearer, according to the publication Politico, hospital associations, ad hoc coalitions of providers, and individual hospitals communicated directly with their members of Congress and deployed their lobbyists to make their case to Congress.  Consequently, while hospitals did suffer some Medicare cuts in the fiscal cliff solution, they were spared the cuts they feared the most.

To learn more about how the hospital industry managed to hold off major Medicare cuts, read this Politico article.…

Will Fiscal Cliff Deal Make Medicare, Medicaid More Vulnerable?

The relative lack of spending cuts included in the fiscal cliff/Medicare doc fix deal passed by Congress last week could increase the pressure to reduce costs in key safety-net programs like Medicare, Medicaid, and Social Security.

Or so some policy analysts believe.

Many members of Congress supported the fiscal cliff bill only reluctantly because of it lacked the bigger spending cuts they sought, the thinking goes.  Now, with another fiscal cliff deadline looming on March 1, when the previously passed sequestration law takes effect, many who compromised last week will be demanding bigger cuts in exchange for their vote.

As a result, Medicare and Medicaid, two of the federal government’s fastest-growing expenses, are expected to be targets for those in search of cuts.  In addition, Medicare has proven to be among the first places many officials look in their search for savings.

Read more about how last week’s budget solution is far from the end of the threat to Medicare and Medicaid in this Boston Globe article.…

Could Hospitals Fall Off Fiscal Cliff?

Hospitals are increasingly worried that policy-makers in Washington will seek to pay their way out of the fiscal cliff crisis with painful Medicare and Medicaid cuts.

Medicare, in particular, seems to be in the sights of fiscal cliff negotiators, and among the cuts being mentioned are reducing outpatient fees, cutting payments to teaching hospitals and rural hospitals, raising the age for Medicare eligibility to 67, and requiring higher-income seniors to pay higher Medicare premiums.

Hospital officials, noting that they already face significant Medicare cuts as part of implementation of the Affordable Care Act, suggest that such cuts could jeopardize access to care for some low-income seniors and lead them to reduce or cut money-losing but essential services.

Read more about the prospect of Medicare cuts and the potential implications of those cuts in this New York Times article.…

Medicaid at Risk in Fiscal Cliff Talks

If Medicaid is a health care program for at-risk low-income people, it appears that Medicaid itself is at risk during the current fiscal cliff talks in Washington, D.C.

While Medicaid was left untouched by last year’s sequestration bill, it is now viewed by growing numbers of policy-makers as a potential source of savings to help stave off the fiscal cliff.

Several aspects of Medicaid, in particular, appear to be vulnerable in the coming weeks.  They include the creation of a new “blended rate” – a single federal matching rate for both Medicaid and CHIP that could save the federal government nearly $15 billion in the coming years; Medicaid provider taxes, which are incurring growing opposition in Washington and which, if ratcheted back, could save more than $25 billion; supplemental payments for Medicaid primary care providers, scheduled to take effect on January 1, which if eliminated would save $13 billion; better management of dual eligibles, which could save $12 billion; and medical equipment spending, where a competitive bidding program similar to that currently being introduced for Medicare could save $5 billion.

Learn more about how Medicaid figures in the current fiscal cliff talks and how policy-makers are increasingly looking to Medicaid …

Old Medicare Proposals Resurface in Fiscal Cliff Talks

Proposals for how to reduce federal Medicare spending that were once thought dead are finding new life in the current fiscal cliff crisis debate.

In particular, recommendations offered by the 2010 Bowles-Simpson commission are being recirculated as Congress and the White House search for ways to avert the fiscal cliff.

Among those that would affect hospitals are reductions in Medicare bad debt reimbursement and medical education payments.

Read about “The Return of Simpson-Bowles in the Medicare Debate” in this Medicare NewsGroup article.…