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Medicare spending disparities not reflected in cancer survival rates

A study concluding that there was no clear association between the survival rates of advanced cancer patients and the amount that Medicare spent on their care suggests that more doctors should be looking to health care delivery models that focus on palliative, patient-centered care rather than aggressive interventions, health care observers said. “Improvements in outcomes for patients with advanced cancer have been limited,” stated the study, which was published online in the Journal of the National Cancer Institute on March 12. New therapies for those with advanced cancer often are very expensive but extend the patient's life by only weeks or months. Other studies looking at regional differences in medical spending have not always found improved outcomes when spending is higher. To assess a possible correlation between medical spending and survival rates, Gabriel Brooks, MD, a medical oncology fellow with the Dana-Farber Cancer Institute, and fellow researchers examined both ...

Urgency intensifies on call to repeal Medicare SGR

Congress’ official Medicare advisers have joined the growing chorus of policy experts who say the program may never again be in as favorable a position to overhaul the formula that helps determine physician pay as it is now. The annual March report to Congress from the Medicare Payment Advisory Commission renewed a proposed policy, first outlined in October 2011, to repeal the Medicare sustainable growth rate and replace it with a decade of set annual payment updates for physicians. In testimony to the House Ways and Means health subcommittee on March 15, the day the newest report was issued, MedPAC Chair Glenn Hackbarth outlined what is at stake for lawmakers on the Medicare payment issue if they go another year without taking the commission’s advice. “The need to repeal the SGR is urgent,” Hackbarth said. “Deferring repeal of the SGR will not leave the Congress with a better set of choices, as the array of new payment models is unlikely to change, and SGR fatigue is i ...

Medicaid nonexpansion states could leave millions uninsured

More than 5 million of the poorest individuals may not be able to obtain health insurance under the Affordable Care Act, resulting in higher uncompensated care costs for health care systems, an analysis has concluded. Starting in 2014, states have the option of expanding eligibility for their Medicaid programs to 133% of poverty (an effective rate of 138% when certain income is discounted from consideration). In states that don't expand Medicaid, most individuals from 100% to 400% of poverty would be eligible to apply for federal premium tax credits to buy coverage from the health insurance exchange that will operate in their states. But for those below the poverty line, no subsidized insurance options may exist in non-expansion states. “In states that choose not to expand, there are some 5.3 million individuals who fall above their state's Medicaid eligibility level but below 100% of the federal poverty level and thus aren't eligible” for the federal exchange subsidies, acco ...