Pain zones in a heart attack.
The Centers for Medicare and Medicaid Services wants to pay hospitals fixed amounts for treating the heart attacks of people on Medicare, rather than letting providers bill for every service provided, the Obama administration said July 25.
The proposal would also introduce target prices for hip and femur fractures.
The expected announcement follows a CMS proposal to offer set reimbursements for hip and knee replacements and is part of a wider program to curb costs and improve the quality of care for all Medicare patients.
Under the cardiac program announced July 26, hospitals would ultimately be offered a target price for all of the services provided in hospital and within 90 days after discharge. If they billed for less, they could keep the savings, but if they billed for more, they’d have to repay Medicare.
The plan would be mandatory for almost all hospitals accepting Medicare in 90 metropolitan areas. The plan is to phase in the program over a five-year period, starting next July 1.
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