Healthcare Financial News

Medicare could save an estimated $500 million per year by expanding the multiple procedure payment reduction (MPPR) policy beyond the designated imaging and surgical services, the Government Accountability Office (GAO) concludes in a new report.

Under an MPPR, the full fee is paid for the highest-priced service and a reduced fee is paid for each subsequent service to reflect efficiencies in overlapping portions of the practice expense component—clinical labor, supplies, and equipment. For example, a nurse’s time preparing a patient for a medical procedure or a technician’s time setting up the required equipment is incurred only once.

According to the report, the Centers for Medicare & Medicaid Services plans to study the potential impact of the policy on other nonsurgical services that are commonly furnished together.

Cardiac resynchronization therapy defibrillators reduce hospitalizations among patients with mild heart failure, according to a study published in the New England Journal of Medicine. These implanted devices try to slow heart failure by correcting inefficient heartbeats, in contrast with standard defibrillators, which  deliver a jolt after the heart stops. The resynchronizing defibrillators cost approximately $30,000 each.

After an average of 2.4 years, about 17.2 percent of study patients with a resynchronizing defibrillator had been hospitalized or intensively treated for heart failure, or had died. The corresponding figure for patients with a standard defibrillator was 25.3 percent. About 7 percent of patients in each group died.

The four-year study of 1,820 patients was funded by Boston Scientific.

In an accompanying editorial, University of Pennsylvania cardiologist Mariell Jessup noted that based on study results, 12 patients would need to be treated to prevent one heart-failure event.