Reflex: November 23, 2011

The CDC reports on physician assistant and advance practice nurse care in hospital outpatient departments: United States, 2008–2009. “Hospital outpatient department visits attended only by physician assistants (PAs) or advance practice nurses (APNs) increased by 50% from 2000–2001 (10%) through 2008–2009 (15%).” Aaron’s comment: The whole report is worth a read. This is a trend that’s likely to continue. Mid-level practitioners offer a cost-effective solution to the doctor shortage in the United States in many areas.

According to analysis by Avalere, hospitals will be hardest hit by triggered Medicare cuts, reports Sam Baker (The Hill). Avalere’s analysis says Medicare will be hit with $123B in cuts to providers. “[T]he provider cuts break down as follows: 32 percent to inpatient hospital care, 15 percent to Medicare Advantage plans, 12 percent to physicians, 8 percent to outpatient hospital care, 7 percent to nursing homes, 4 percent to home health agencies, 3 percent to a small portion of the Medicare prescription drug benefit not exempt from the trigger.” Austin’s comment: This is all on top of cuts designated by the ACA. Relative to what private insurers pay hospitals and according to the CMS Office of the Actuary, those ACA cuts look like this: 

If you think this is problematic, I agree with you.

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