• Medicare’s annual (non-physician) productivity adjustments

    This is even deeper into the weeds than I normally dare travel. Nevertheless, if Ezra Klein can handle it, so can I. His correction to an earlier post, about which I commented, mentions “the annual productivity adjustments [which] are not held to GDP+1. They’re held to ‘a 10-year moving average of economy-wide private, non-farm productivity.'”

    Oh boy! What’s that about? Quick, to Google. Fly, fingers, fly …

    Jennifer A. Stiller seems to know:

    The Health Reform statute […] applies this productivity adjustment by —

    • Including it in the annual updates for inpatient and outpatient acute-care hospital services, skilled nursing facility (“SNF”) services, inpatient rehabilitation facility services, dialysis, , ambulance services, and clinical laboratory services, beginning in 2012;
    • Including it in the annual update for hospice care, beginning in 2013.
    • Applying it to the annual update of the base rates for long-term care hospitals (“LTCHs”) and for inpatient psychiatric hospital services, to the extent that either of those base rates is subject to such an update, starting in 2012;
    • Applying it to the annual market basket increase for home health agency services, beginning in 2015; and
    • Including it in the annual percentage change factor applicable to ambulatory surgical center (“ASC”) services, to the extent such a factor applies, starting in 2011.
    • Using it to reduce the consumer price index-based covered item update for durable medical equipment (“DME”) and other similarly based fee schedule updates, beginning in 2011.

    The reductions in the annual update factor for each of the 15 types of provider and supplier imposed by the PPACA are detailed below.

    Yes, there’s even more glorious detail in Stiller’s post. Here’s where I get off the wonk train, for now.

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