Administration's 1994 Health Budget: Hearing Before the Committee on Finance, United States Senate, One Hundred Third Congress, First Session, April 1, 1993, Volume 4 |
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4-Year Total ACLA administration's proposal American anesthesia anesthesia services anesthesiologists ASIM Association average believe beneficiaries budget proposal CHAIRMAN changes charges per episode clinical laboratory clinical presentations Committee Congress conversion factors coverage current law diagnostic imaging direct billing disability durable medical equipment estimates facilities federal fee schedule Finance fraud and abuse Funds graduate medical education HCFA health care reform health care system imaging charges imaging examinations incentives increase inpatient matching rates Medicare and Medicaid Medicare payment Medicare program mental illness oncologists Pap smear pathologists pathology patients payment system percent physical therapy physician payment physician self-referral practice expense procedures radiation oncology radiation therapy radiologist-referring physicians radiologists radiology RAP DRG RBRVS reduce referral reimbursement relative value residents result rural RVUS Savings in millions self-referral self-referring physicians Senator PACKWOOD SHALALA Social Security specialty spending statement surgery surgical teaching hospitals update
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Page 46 - ... bundles" or packages of services, capitated payments, and negotiated contracts for selected services. The Medicare Program's Role In Graduate Medical Education Financing To provide experientially-based clinical training for physicians, dentists, nurses, and allied health professionals, hospitals incur educational costs related to patient care. For graduate medical education, these added costs include resident stipends and benefits, salaries and benefits for faculty who supervise residents in...
Page 78 - Mr. Chairman and members of the Committee. I am honored to appear before you today to discuss the President's FY 2003 budget for the Department of Health and Human Services (HHS).
Page 43 - This adjustment is provided in light of doubts . . . about the ability of the DRG case classification system to account fully for factors such as severity of illness of patients requiring the specialized services and treatment programs provided by teaching institutions and the additional costs associated with the teaching of residents . . . the adjustment for indirect medical education costs is only a proxy to account for a number of factors which may legitimately increase costs in teaching hospitals...
Page 46 - Bach hospital's per resident amount is determined by dividing its allowable base year costs by the number of full-time equivalent (FTE) interns and residents at the hospital during that base year. The per resident amount is then updated for inflation and multiplied by the number of FTE interns and residents in the hospital complex during the payment period. Residents are weighted at 1.0 FTE for the residency period required for initial board certification plus one year, not to exceed a total of five...
Page 144 - ... ultimately puts forward. The APA asks simply that psychiatrists and their patients be treated like all other physicians and patients are treated under a reformed health care system. We should be subject to the same cost constraints and the same internal reviews as are other physicians and patients. We should be subject to the same outcomes measurements as are imposed on other medical specialties and their patients. These studies will show what we have known all along: mental illnesses are real...
Page 48 - While strongly supporting more individuals entering primary care, the AAMC does not believe this result can be achieved by manipulating hospital payment. On the contrary, personal incentives such as loan forgiveness, tax benefits, and other inducements are more likely to result in greater numbers of US medical school graduates entering the primary care disciplines.
Page 45 - ... goals adopted, and initiatives undertaken both by the Association of American Medical Colleges and the University of Minnesota Medical School to increase the supply of generalist physicians. The AAMC is committed to increasing the number of generalist physicians and has adopted a policy statement that calls for an overall national goal that a majority of graduating medical students be committed to generalist careers...
Page 145 - Let me cite one specific example. Briefly, the rbrvs for psychiatric services just does not work very well. A particularly problem is the fact that most psychiatric services are highly time dependent. As a result, psychiatrists, for example by their most used CPT 4 Code (90844), cannot respond to expected reduced payment under the Medicare Fee Schedule (MFS) by increasing volume or intensity of service — yet this is the basic assumption applied to ftii physician and nonphysician services covered...
Page 128 - ACR's third concern with the budget proposal is related to funding for training physicians. We believe it is inappropriate to arbitrarily decide that funding for training specialists should be reduced. The need for specific specialists should be based on need and not perception. Changing the supply of specific specialties is not a panacea for eliminating inappropriate utilization of medical services. It is more appropriate to determine need for services and provide sufficient numbers of specialists...
Page 136 - O&P is strictly defining orthotics as "braces" and prosthetics as "artificial limbs", and proposes that Congress do the same. Orthotics and prosthetics are radically different from durable medical equipment in that O&P health care "services" are highly individualized to specific patient needs, and are as much a professional "service" as a "product". The "product...