The times, they are a-changin’. And now so is Medicare.
If your perception of Medicare is that it’s a behemoth system, mired in red tape and utterly resistant to change, you aren’t alone. But in 2016, it seems, we’re in for a Medicare surprise.
Of course, it isn’t unusual for bureaucracy to ring in the New Year with a few minor modifications. This year’s series of Medicare changes, though, are some of the biggest we’ve seen in the last 50 years.
Mind you, change isn’t always for the better. And to be sure, the jury is still out on some of these, as CBS News makes clear in their latest report. But others seem like real winners. Let’s take a look, and we’ll let you be the judge.
- End-of-Life Counseling Coverage — Among the many Medicare changes for 2016, the decision to finally pay for beneficiaries’ end-of-life counseling services has generated the biggest buzz by far. Clinicians will now be able to review patients’ different treatment options with them as they move into their final chapter of life.
- Hospitals on the Hook for Hip & Knee Replacement — Medicare will now pay hospitals a single “bundled payment” that will cover 90 days’ worth of treatment for a patient’s hip and knee problems. In the past, hospitals were able to charge for each individual procedure as a stand-alone service, regardless of the outcome. Now, the hospital will be paid one fee in total for fixing the hip/knee problem over the course of 90 days. Essentially, payment is now focused on the outcome rather than on the individual procedures. Some say that will force hospitals to “get things right” in order to “earn” the prize for healing the patient. Others say it will encourage hospitals to skimp on care and do as little as possible so they can minimize their own costs. Who’s right? Only time will tell. This particular Medicare change is only a test — it’s mandatory in just 67 U.S. communities and begins in April.
- No More “Hospice vs. Healing” — Until now, terminal patients had to choose whether their Medicare would pay for hospice or for curative medical care. They couldn’t have both. Now they can. This rule is already in effect in 70 hospices around the country (as of 1/1/16). Another 70 will join by 2018.
- Accountable Care Organizations — ACOs are networks of doctors and hospitals that work together to provide you better care at a lower cost. Medicare offers these ACO providers a financial incentive for coordinating their care. Currently, only about 20% of Medicare beneficiaries are in ACOs, but that number is expected to increase considerably during 2016. Experts are still waiting to see whether the program will prove as effective in practice as it should in theory.
Changes in Medicare are enough to make anyone nervous. But to the extent that they could pave a real path toward progress, they can be exciting too.
At Bennett Watson Trust & Estate Elder Law, LLC, we know how important Medicare is to many of our clients and their families. If you have questions, please don’t hesitate to reach out and ask.