Medicare: Better Information Can Help Ensure That Refinements to BBA Reforms Lead211 to Appropriate Payments. Statement of William J. Scanlon, Director Health 211 Financing and Public Health Issues, Health, Education, and Human Services 211 Division

摘要

The author's comments focus on payment reforms affecting certain providers in211u001eMedicare's traditional fee-for-service program and providers in Medicare's 211u001emanaged care program. Specifically, The author will discuss the effects on three 211u001eproviders of post-acute care services-home health agencies (HHA), skilled nursing 211u001efacilities (SNF), and providers of outpatient rehabilitation therapy-and the 211u001ehealth plans participating in the Medicare+Choice program. In brief, some 211u001eproviders of post-acute care and health plans in the Medicare+Choice program may 211u001ehave to rethink their business strategies as a result of BBA payment reforms 211u001ewhich seek to make Medicare a more efficient and prudent purchaser. Imperfections 211u001ein the design of BBA-mandated payment systems require attention, and better 211u001einformation can help policymakers distinguish between desirable and undesirable 211u001econsequences. Based on such knowledge, refinements can help ensure that payments 211u001eare not only adequate in the aggregate but are also fairly targeted to protect 211u001eindividual beneficiaries and providers. The authors' issued and ongoing studies 211u001eof various payment methods are instructive in this regard, and a summary of the 211u001eauthors' results to date follows.