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“Medicare for All” isn’t equitable for all hospitals
A payment model in which 100% of payments are based on Medicare rates should take into account the inherent disadvantages of such an approach for the large hospitals, including academic medical centers, that provide most Medicare outlier cases.
Implications for a CFO-led strategic response to a Medicare-based payment system
If a payment model that bases payment on Medicare rates is adopted, CFOs should prepare for its financial implications by implementing a modified benchmarking system that accounts for outliers.
A single-payer system based on Medicare rates poses inherent challenges
A payment model under which 100% of payments are based on Medicare rates r\aises important questions of how to fund such a plan.
Transitioning to a New Medicare Benchmarking Paradigm
As commercial health plans adopt a case-rate approach to payment based on Medicare’s MS-DRGs, modifications are needed to account for how health plans’ populations differ from the Medicare population.