Medicare
Compared to the rest of the country, Iowa (at 17 percent) ranks near the top among states in its proportion of Medicare beneficiaries and, at 13 practicing physicians per 1,000 beneficiaries, ranks close to last among states in its ratio of physicians to Medicare beneficiaries. Additionally, Medicare reimbursement to Iowa physicians ranks among the lowest in the country - averaging around 80th out of 89 payment localities. Despite these factors, nationwide the quality of Iowa's health care is ranked 2nd overall.
The American Medical Association (AMA) says the Centers for Medicare & Medicaid Services (CMS) has announced that implementation of the Phase 2 ordering and referring denial edits has been delayed. The edits, which will deny certain claims if the ordering or referring provider has not either...
IMS has been telling physicians about the Quality Resource and Use Reports (QRURs) and the Value-Based Payment Modifier (VBM) which will begin to affect Medicare fee-for-service payments in 2015 and expand to all physicians by 2017. In early 2012, the Centers for Medicare & Medicaid Services (CMS)...
Ardis D. Hoven, MD, AMA president-elect, issued the following statement about the final Medicare fee schedule:
"The American Medical Association (AMA) is pleased that CMS included some of our key recommendations in the final Medicare fee schedule rule, including adopting the CPT codes for transitional...
The Institute of Medicine’s Committee on Geographic Adjustment Factors in Medicare Payment released its supplemental findings and recommendations to its June 1 report on the geographic practice cost indices (GPCIs) for physicians and the geographic wage index for...
Medicare payment equity through reform of the geographic practice cost indices (GPCIs) remains a top advocacy priority for IMS. Medicare's proposed calendar year (CY) 2012 physician payment rule indicates a five percent drop in Iowa's geographic adjustment factor (GAF), due in large measure to the January...
The Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare payment policy, has recently discussed the possibility of adopting a proposal to address the SGR. The proposal would repeal the SGR using a broad range of budget offsets. However, to bring down the cost of repeal,...
The Institute of Medicine (IOM) has released its initial report on Geographic Equity in Medicare Payment with a national conference call on June 1. IMS leaders and staff participated in the call.
It is too early to ascertain the impact of the initial set of recommendations on Iowa physician practices, and the final report...