New Medicare Payment Plan For Heart Attacks Will Press Hospitals To Monitor Post-Acute Care
The plan, which will be implemented in nearly 100 communities, will bundle Medicare reimbursements for coronary bypass surgery and heart attack treatments to include care delivered by skilled nursing and rehab facilities. Also in the news, some Medicare beneficiaries are surprised to find out that they have been automatically enrolled in a Medicare Advantage plan.
Modern Healthcare:
Hospitals Will Pivot To Post-Acute Care To Thrive Under Cardiac Bundles
Under a proposed demonstration program that would start July 1 next year in 98 randomly selected areas, Medicare would pay hospitals under a bundled-payment model for coronary bypass surgery and treatment for heart attacks. The hospitals would get a set amount per medical episode to cover the hospitalization and all of the related care for 90 days after the patient is discharged. That puts hospitals at financial risk for managing the quality and efficiency of care delivered by a variety of post-acute providers, including skilled nursing and rehabilitation facilities and home health agencies. (Whitman, 7/26)
Kaiser Health News:
Some Seniors Surprised To Be Automatically Enrolled In Medicare Advantage Plans
With Medicare’s specific approval, a health insurance company can enroll a member of its marketplace or other commercial plan into its Medicare Advantage coverage when that individual becomes eligible for Medicare. Called "seamless conversion,” the process requires the insurer to send a letter explaining the new coverage, which takes effect unless the member opts out within 60 days. (Jaffe, 7/27)