States to see adjustments in Medicare reimbursements


Oregon and Washington hospitals and doctors can look forward to increased Medicare reimbursements under the health-care overhaul.

U.S. Rep. Peter DeFazio, D-Springfield, said Monday he and other members of Congress were ready to vote against the bill to win steps to correct long-standing geographic inequities in Medicare reimbursements that hurt 17 states, including Oregon.

"This is the first increase over and above inflationary increases in two decades," DeFazio said from Washington, D.C. "We had to play hardball. We had to get out the steel bats."

It's the same story in Washington, which comes in at 35th place for Medicare reimbursement rates, according to Jim Stevenson at the state's Department of Social and Health Services. "Washington is one of the states that is historically low. Our congressional delegation has fought to increase that over the years."

Oregon hospitals should see an immediate increase of about 1.5 percent, and physicians about 4 percent under a provision that dedicates $400 million over the next two years to increasing Medicare reimbursement rates in states that historically have gotten less, DeFazio noted.

Obama's plan is a short-term fix, Stevenson said. "The rates should go up for Medicare. That doesn't really change Medicaid rates, but eventually this would have an impact on those rates."

The bill calls for a long-term fix in the future, he said. "So this won't happen again."

Oregon has about 600,000 people on Medicare. DeFazio said he regularly gets calls from seniors who cannot get a doctor because of the low rates.

Oregon's 2008 Medicare hospital billings per capita of $11,598 rank it 47th in the nation, and amounts to less than half the rate for New Jersey, Pennsylvania and Alaska, according to the Oregon Association of Hospitals & Health Services Web site.

According to the Dartmouth Atlas of Health Care, Washington state spends a yearly average of $7,100 per Medicare patient, compared to the national average of $8,300. On the higher end, New York spends $9,560, Stevenson said.

Association spokesman Andy Van Pelt said the $400 million is a good start, but Medicare and Medicaid reimbursements for doctors and hospitals fell short by $1.7 billion in Oregon alone in 2007.

The Obama administration also agreed to undertake two studies by the Institute of Medicine to correct geographic inequities, costs, access and health care value. The deadline for changes is December 2012.

No one knows exactly what reimbursement will look like, Stevenson said. "This is not going to change the state's budget picture, this is a federal program." Doctors are beginning to leave the Medicare fold because of low reimbursement rates, he added.

Health and Human Services Secretary Kathleen Sebelius will also convene a national summit on the issues later this year.


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