Medicare Seeks Better Care Coordination

Blog Post
Tuesday, August 19, 2014

In a change that some experts say could save money and improve patient care, Medicare in January will begin making special payments to doctors and others to coordinate care for beneficiaries with two or more chronic illnesses.

Federal officials suggest that such separate payments could pay for themselves by keeping patients healthier and out of hospitals, according to The New York Times, which reported this week on the policy change. Health care providers will receive about $42 a month for coordinating a Medicare beneficiary’s care.

Two-thirds of Medicare beneficiaries have two or more chronic conditions.  According to federal statistics, they account for 93 percent of Medicare spending.

The Centers for Medicare and Medicaid Services (CMS) has also accepted recommendations from the Government Accountability Office  (GAO) to improve claim reviews. The GAO recently faulted the review process for Medicare claims, saying CMS lacked reliable data and had failed to provide sufficient oversight and guidance for its contractors.

Because Medicare is a key driver of projected federal deficits, officials must make every effort to ensure that improper payments and costly mistakes are held to a minimum.

External links:Medicare to Start Paying Doctors Who Coordinate Needs of Chronically Ill Patients (N.Y. Times)Medicare Program Integrity Report (GAO)Older Patients Are Getting Screened Way Too Often (Vox)Overbilling by Medicare Advantage Plans (Center for Public Integrity)