Here, there and everywhere. With the release of MedPAC report on differences in regional Medicare spending, some providers are concerned government might overreact

A MedPAC report that details regional differences in Medicare service use has providers worried what solutions policymakers will come up with to deal with the disparities. The study "compels us to ask why the variation is occurring and what steps can be taken now to rein in the variation where it is unjustified," says Karl Ulrich, left, of the Marshfield (Wis.) Clinic.

The coming storm Medicare wage index overhaul signals changes for hospitals

Recent recommendations by the Medicare Payment Advisory Commission (MedPAC) could, if implemented, substantially alter the wage index-and redistribute billions to hospitals in the process. The Centers for Medicare & Medicaid Services (CMS) is expected to publish its recommendations soon. Whether CMS will endorse or reject MedPAC's recommendations is unclear.

What does the future hold for hospice in the present envirornment?

This has been a monumentalyear for Medicare Hospice Benefit (MHB) providers. Rapid growth in expenditures ($10 billion in 2007) and anticipated doubling of that figure in the next 10 years has drawn more attention, notably from the Centers for Medicare & Medicaid Services (CMS), the Congress, the Medicare Payment Advisory Commission (MedPAC), and Office of Inspector General (OIG). In 2007, about 40 percent of Medicare decedents used hospice compared to about 27 percent in 2000. Between 2004 and 2005, spending on hospice increased by 20 percent as compared to about a nine percent increase for overall Medicare spending. MedPAC estimates that the number of patients receiving hospice care for more than six months has increased from 14 percent in 2000, to 21 percent in 2005. How has the government responded to this growth?

Health plans target advanced imaging services: cost, quality and safety concerns prompt renewed oversight

Faced with double-digit annual increases in the use of advanced imaging services, health plans are stepping up efforts to manage imaging utilization, maintain imaging quality and ensure patient safety, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Plan strategies range from informing physicians about evidence-based imaging guidelines to requiring prior authorization of services to credentialing physicians and imaging equipment. Mindful of the physician backlash against managed care in the 1990s, plans are instituting requirements they perceive to be less intrusive and burdensome for physicians. Some physicians, however, view the requirements as administratively onerous and obstacles to patient care. Depending on the experience with imaging, plans may expand utilization management to other services with rapid volume increases.