Health Care And The Fiscal Cliff Deal

Harvard professor and author John E. McDonough

Harvard professor and author John E. McDonough

I don’t know about you but I never want to hear about the “fiscal cliff” ever again.

But for true wonks who wish to close the loop on what actually emerged from that final, chaotic and infuriating flurry of legislative wrangling earlier this week, here’s John McDonough, this town’s go-to guy for level-headed health care analysis, offering details in The Boston Globe.

Aside from the major fix to doctors’ Medicare payments (the deal prevents a 30% drop in physician fees) McDonough notes some other items that you probably heard nothing about:

There are 29 Medicare and other health related sections in all. Here are some of the big ones:

–The big “pay-for” cuts $10.5B from Medicare hospital payments to recoup over-payments to hospitals.
–Payment adjustments for End Stage Renal Disease (ESRD) will save $4.9B.
–Rebasing payments for Disproportionate Share Hospitals (DSH) will save $4.2B.
–Rejiggering the coding intensity between Medicare Advantage and Medicare fee-for-service will save $2.5B.
–$1.8B will be saved from reduced payments for certain therapies provided on the same day.
–Eliminating the Medicare Improvement Fund will save $1.7B.
–Throw in a bunch of smaller items less than $1B in savings, and we end up with only a net $1.7B increase in spending over 10 years.

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