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Geographic Adjustment in Medicare Payment - Phase I: Improving Accuracy (Paperback, 2nd Revised edition)
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Geographic Adjustment in Medicare Payment - Phase I: Improving Accuracy (Paperback, 2nd Revised edition)
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Medicare is the largest health insurer in the United States,
providing coverage for 39 million people aged 65 and older and 8
million people with disabilities, and reaching more than an
estimated $500 billion in payments in 2010. Although Medicare is a
national program, it adjusts fee-for-service payments according to
the geographic location of a practice. While there is widespread
agreement about the importance of providing accurate payments to
providers, there is disagreement about how best to adjust payment
based on geographic location. At the request of Congress and the
Department of Health and Human Services (HHS), the Institute of
Medicine (IOM) examined ways to improve the accuracy of data
sources and methods used for making the geographic adjustments to
payments. The IOM recommends an integrated approach that includes
moving to a single source of wage and benefits data; changing to
one set of payment areas; and expanding the range of occupations
included in the index calculations. The first of two reports,
Geographic Adjustment in Medicare Payment: Phase I: Improving
Accuracy, assesses existing practices in regards to accuracy,
criteria consistency, evidence for adjustment, sound rationale,
transparency, and separate policy adjustments to reform the current
payment system. Adopting the recommendations outlined in this
report will mean a change in the way that the indexes are
calculated, and will require a combination of legislative,
rule-making, and administrative actions, as well as a period of
public comment. Geographic Adjustment in Medicare Payment will
inform the work of government agencies such as HHS, the Centers for
Medicare and Medicaid Services, congressional members and staff,
the health care industry, national professional organizations and
state medical and nursing societies, and Medicare advocacy groups.
Table of Contents Front Matter Summary 1 Introduction and Overview
2 Labor Markets and Payment Areas 3 Hospital Wage Index 4 Smoothing
the Borders of Labor Markets and Payment Areas 5 Geographic
Practice Cost Indexes 6 Transitions Appendix A: Committee and Staff
Biographies Appendix B: Public Committee Meeting Agendas Appendix
C: List of Contributors and Participants Appendix D: Statistical
Reliability of the Bureau of Labor Statistics (BLS) Wage Data
Appendix E: Comparison of the Medicare Payment Advisory Commission
(MedPAC) and Institute of Medicine (IOM) Proposals for Alternative
Hospital Wage Indexes (HWIs) Appendix F: Description of Three
Optional Sources for Facility Wage Index Data Appendix G: RTI
Analysis Data Sources Appendix H: S-3 Worksheet Appendix I:
Physician Work Adjustment Index
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