HCFA tries bundling payments and negotiating new PSO rates
HCFA tries bundling payments and negotiating new PSO rates
HCFA has announced a new Medicare Provider Partnership project that will pay one lump sum bundled rate, combining both hospital and physician services for beneficiaries in acute care institutions participating in the project. The goal of the project is to encourage physicians and hospitals to work together more efficiently in theory, providing better quality of care for less money.
In a separate action, HCFA also said it has instituted a rarely used negotiated rule-making process to create payment rates for newly approved physician service organizations (PSOs).
HCFA hopes its use of using a negotiated rule-making process, rather than the usual preliminary public comment format, will speed the process and allow a common consensus to be developed in time to meet the April 1998 deadline set by Congress to have a PSO rate rule in place. A negotiated rule-making process is much like negotiating a collective bargaining agreement, whereby various interested groups and HCFA officials literally meet together to present proposals and, hopefully, hammer out consensus language for a proposed rule.
The groups expected to participate in these negotiated rule-making sessions include: the American Association of Health Plans, American Association of Retired Persons, American Hospital Association, American Medical Association, Consortium of Citizens With Disabilities, Federation of American Health Systems, National Association of Insurance Commissioners, and the National Rural Health Association.
Physician’s Payment Update will keep readers informed of these developments as they occur.
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