MEDICARE: FEE DISCREPANCY SPURS CALL FOR FEDERAL REVIEW
A "wide discrepancy in county-to-county" Medicare fees "hasThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
prompted some consumer groups to call for a federal review of the
Medicare fee system," DETROIT NEWS reports. According to the
Health Market Survey's list of per patient Medicare fees for the
nation's 22 most expensive counties, the discrepancy between the
most and least expensive county is $208.08. Stephen Zuckerman, a
health care economist for the Urban Institute, said that the fees
"are influenced by physician wages, rent, malpractice insurance
and other factors." However, DETROIT NEWS reports that critics
contend that "there should be more uniformity to" the fees.
Terry Brooks, a health care attorney in Washington, DC, said that
the fee discrepancy is a "major, major issue." Congress has
scheduled hearings on the fee discrepancy issue for the spring.
UNRULY SYSTEM: Currently, Medicare fees for health care
services are set on the national level "and then adjusted at the
county level to account for differences in related health care
costs, such as the cost of living and malpractice insurance."
However, Bill Boyles, editor of Health Market Survey, a
Washington, DC, trade publication that covers the managed care
industry, questioned the fee discrepancies. He said, "Are the
doctors providing higher quality services? They are spending too
much and prescribing too many unneeded services ... that's the
TOP SPENDERS: Richmond County, New York tops the list
spending an average $767.35 per patient. Dade County, Florida
comes in second at $748.23, followed by Bronx County, New York at
$728.24. New York and Kings counties in New York follow at
fourth and fifth, respectively. Philadelphia County,
Pennsylvania placed sixth, spending $704.25; Los Angeles County,
California ranked 11th at $622.55. And Cook County, Illinois
placed 22nd, spending $559.27. DETROIT NEWS reports that the
national average of county Medicare fees is $488.25 (see AHL
9/9) (Raphael, 9/22).