By Margaret Edmunds, Frank A. Sloan, Committee on Geographic Adjustment Factors in Medicare Payment, Board on Health Care Services, Institute of Medicine
Medicare is the most important overall healthiness insurer within the usa, offering assurance for 39 million humans elderly sixty five and older and eight million individuals with disabilities, and attaining greater than an envisioned $500 billion in funds in 2010. even if Medicare is a countrywide application, it adjusts fee-for-service funds in response to the geographic place of a convention. whereas there's common contract concerning the value of delivering exact funds to prone, there's war of words approximately how most sensible to regulate money in line with geographic situation. on the request of Congress and the dept of well-being and Human prone (HHS), the Institute of drugs (IOM) tested how you can increase the accuracy of information resources and strategies used for making the geographic alterations to funds. The IOM recommends an built-in procedure that comes with relocating to a unmarried resource of salary and advantages facts; altering to at least one set of money parts; and increasing the variety of occupations integrated within the index calculations. the 1st of 2 studies, Geographic Adjustment in Medicare fee: section I: bettering Accuracy, assesses current practices with reference to accuracy, standards consistency, facts for adjustment, sound motive, transparency, and separate coverage alterations to reform the present money method. Adopting the techniques defined during this record will suggest a transformation within the means that the indexes are calculated, and should require a mixture of legislative, rule-making, and administrative activities, in addition to a interval of public remark. Geographic Adjustment in Medicare fee will tell the paintings of presidency organisations resembling HHS, the facilities for Medicare and Medicaid providers, congressional participants and employees, the healthiness care undefined, nationwide expert businesses and nation scientific and nursing societies, and Medicare advocacy teams.
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Additional info for Geographic Adjustment in Medicare Payment: Phase I: Improving Accuracy, Second Edition
The committee noted that a number of improvements could be made to both indexes through a similar strategy or data source. PREPUBLICATION COPY: SECOND EDITION Copyright © National Academy of Sciences. All rights reserved. Geographic Adjustment in Medicare Payment: Phase I: Improving Accuracy, Second Edition SUMMARY S-7 6. Transparency. The geographic adjustment process should provide sufficient information to allow transparency and empirical review of the data and methods used to make the adjustments.
Specifically, the committee will • Evaluate the accuracy of the adjustment factors; • Evaluate the methodology used to determine the adjustment factors; and • Evaluate the measures used for the adjustment factors for timeliness and frequency of revisions, for sources of data and the degree to which such data are representative of costs, and for operational costs of providers who participate in Medicare. S. health care marketplace, the committee will also evaluate and consider: • The effect of the adjustment factors on the level and distribution of the health care workforce and resources, including: recruitment and retention taking into account mobility between metropolitan and nonmetropolitan; ability of hospitals and other facilities to maintain an adequate and skilled workforce; and patient access to providers and needed medical technologies; • The effect of adjustment factors on population health and quality of care; and • The effect of the adjustment factors on the ability of providers to furnish efficient, high- value care.
Monthly rent v. price per square foot), which made comparisons difficult. Based on the limitations associated with each data source, such as low response rates, small sample sizes, and sample bias, the committee concluded that all of these sources would be imperfect or geographically incomplete proxies for variation in physician office rental costs. Because the committee also concluded that the cost of space is not adequately measured with residential data, the committee recommends the development of a new data source.