A Huge Threat to the U.S. Budget Has Receded. And No One Is Sure Why. (Medicare)

A Huge Threat to the U.S. Budget Has Receded. And No One Is Sure Why. - The New York Times (nytimes.com)

For unknown reasons, Medicare spending per beneficiary has gone flat for over a decade.

That's good news!

Far from being a run-a-way spending item, it looks like things have stabilized, at least for now. And it's saved almost $4 trillion in actual spending vs. what was projected to be the cost by 2023! This was based on a 10-year projection.

So, who will be the first to admit that Medicare might not be going bankrupt in the future like everyone thought?

 

Cost per patient has stayed flat, medicare as a total yearly cost continues to rise and is projected to do so through 2030s. Personally i find it an acceptable expense, i think its more detrimental not to have people covered. I just hope we can keep up and continue to provide said care with these alarming immigration numbers that continue to come legally and illegally.

 

One smart thing that they did was create a Medicare Shared Savings Program (MSSP) where Accountable Care Organizations can get a bonus based on keeping costs below a benchmark. The more below, the larger the bonus

Shared Savings Program | CMS

 

If you look at the charts it looks like the trend stabilized around 2010 — the same year the ACA was implemented. Isn’t that ironic

Even conservative think tanks including Koch are starting to admit the only way we are going to get control of runaway healthcare spending is to implement policies that will make primary care more accessible to all, regulating pricing and implementing some level of national healthcare program.

It’s funny that the oldest people that are the primary recipient of government healthcare are the ones most fighting against this.

 

I would bet money if Republicans would say we are going to implement a national healthcare program for all US citizens under the sole condition it doesn’t cover non-citizens that Democrats would pass it.

And if they didn’t they would lose the next several elections.

Your thought that taking care of people before the issue becomes major will save money in the long run is very fiscally prudent and logical.

 

I agree many republicans are just against it because democrats support it. I think if we are going to care about unborn babies, we need to care about their health coverage , their parents health coverage, etc.... having people lose their home because of medical bills is simply unacceptable IMO in 2023. Personally I think those that can't afford health care have to be covered one way or another. Not just for fiscal cost, but out of moral obligation as well. If people are working for a corporation, corporation should be responsible for covering those cost of any full time employee and supporting the cost of any part time employees.

 

Reps and Dems support whatever keeps them in power. Neither party cares about your health. Those same people are consuming the subsidized Standard American Diet (SAD) and their suffering produces massive profits for food giants and big pharma. One cannot take a position of moral high ground when supporting either party.

 

It's excellent news, but sobering that:

1) As the article notes, this is easily "the most important thing that has happened to the federal budget in the last 20 years" and yet is rarely talked about or reported on, and most people are probably unaware of it, and

2) The linkage of this trend to the Affordable Care Act is obvious and yet on the rare occasions this story does get some press (including this one), they always feel the need to pretend "no one is sure why."

 

It’s because CMS is nickel-and-diming providers at every opportunity.

 

I am involved in patient billing for Drs/NPs in nursing homes

Reimbursement rates had dropped multiple years in a row (obviously pay rates and other costs kept going up) which negatively impacted our margins.
For this year they increased the value of the cpt codes that we predominantly use, so we finally got a significant increase (even though the overall rates paid by CMS went down as a whole, so I assume other types of providers did get a reduction)

The MSSP money that I mentioned is not guaranteed, so just more challenges for businesses like mine

 

I focus more on the hospital side. Hospitals are employing far more contract labor than ever before (out of necessity, not choice). So their labor costs are way up. CMS is supposed to account for that in the rates but they have decided not to account for increases in contract labor. They say this is fine because contract hours only represent 4% of total hospital labor hours. But that ignores that contractors get a lot more per hour. Contract labor accounts for 9% of total hospital labor costs.

 

I used to be involved in the nursing home staffing part of our business and agency (contractor) costs was a big area of focus for me due to the higher cost (and quality of care) so I understand.