While the shape of overall health reform is still unclear, the word I’m getting is that the cost containment features in the President’s new budget have a very good chance of being passed. These include:
- Cutting radiology costs by $70 million over five years, and by $260 million over the next ten years. This is to be done primarily through the use of Radiology Benefit Managers. (The Medical Imaging and Technology Alliance has already issued a protest.)
- Cutting home health payments to “align with costs” (meaning that providers’ profit margins are too high).
- Basing hospital reimbursements on quality indicators (which the Administration apparently sees as having an overall downward effect).
- Cutting hospital payments when a patient is readmitted within 30 days of discharge (which happens in 17% of Medicare cases).
- Increasing premiums for higher-income Medicare enrollees in drug benefit programs, as is currently done for Plan B. (The proposed cutoff figure is $85,000/year, a number which may rise during negotiations).
We’ll keep tracking these proposals as they come through.