A Medicare proposal plans to issue fixed payments to hospitals for treating heart attack patients instead of health care providers sending bills for each service being provided to senior Americans. This follows the offer for fixed reimbursements for knee and hip replacements.
The new Medicare proposal is an important extension of the current administration's initiatives to improve the health care quality offered by the federal program and cut costs.
Under the proposed payment scheme, the cardiac care patients will be offered a "target price" for all the health services being offered in the hospitals and the services they can get within the 90 days following their discharge.
If the total bill does not meet the target price, the patients will then be allowed to keep the money they didn't get to use and treat it as savings. However, if the total bill exceeds the cost of the fixed price, the patients need to reimburse Medicare.
Once the proposal is approved, all hospitals across 90 metropolitan areas in the United States that accept Medicare beneficiaries will be required to adopt the new fixed payment scheme.
"We think this is a significant positive step forward on behalf of patients. I think we are moving at the right pace. That's absolutely where I would want the delivery system to be focused," said Patrick Conway, the chief medical officer of the agency overseeing Medicare.
On July 25, the U.S. Health and Human Services Department (HHS) also announced a proposal for a new model to help increase the number of patients taking cardiac rehabilitation. At present, only 15 percent of patients who suffered heart attacks undergo cardiac rehabilitation, even though past research discovered it can help lower the risks of suffering from another episode or even death.
The HHS added that they will propose a scheme wherein doctors who take part in the new "bundled" payment models will be eligible for incentive payments upon reaching particular thresholds. In the United States, HHS is the top health care purchaser through Medicare and Medicaid programs.
"Having a heart attack or undergoing heart surgery is scary and stressful for patients and their families. Today's proposal is an important step to improving the quality of care Americans receive and driving down costs," said Sylvia Burwell, the secretary of HHS.
The focus on "episodes of care" and rewards for successful health recoveries could help hospitals come up with coordinated care and help achieve the best possible results through the proposed bundled payments.
