Friday, May 11, 2012

CMS Initiative Releases to Mixed Reviews


According to data from a recent CMS inquiry, nearly a third of the US Government’s $2.6 Trillion debt could be related to excessive medical spending in the nation’s hospitals. The data came to light during the first steps of CMS’s Medicare Spending Per Beneficiary (MSPB) Measure, which will provide financial incentives to hospitals with efficient, patient-oriented care. We first wrote about this CMS initiative in August of 2011.

Now, CMS has set October 2014 as the hard start for MSPB. Supporters believe that the measure will bring about positive changes to the ailing Medicare program, allowing the nation’s largest insurance provider the opportunity to save on some of the exorbitant spending of the past.

Others are less enthusiastic.

UCLA Health System’s Dr. Tom Rosenthal told Kaiser Health News, “I wouldn't take any of these cost measures to the bank…I think we need to know a lot more before we start publishing lists of hospitals and doctors and declaring who is most efficient.” Dr. Rosenthal is referring to CMS’s quiet roll out of the Hospital Compare website, which lists nationwide hospitals, and their MSPB score. Rosenthal, and many other opponents, feel that other factors – such as the well-known regional spending and health care usage discrepancies – could paint an inaccurate picture.

There is still plenty of time between today and 2014’s October roll out, but most experts agree that CMS’s first steps have been successful, even if a little imperfect.

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Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.

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