Medicare's Policies and Prospective Payment Rates for Cardiac Pacemaker Surgeries need Review and Revision.
Abstract
This report discusses Medicare's hospital prospective payment rates for cardiac pacemaker surgeries and the changes that have occurred in the pacemaker field since the data used to compute these rates were accumulated that could affect the rates' reasonableness. In fiscal year 1983, the Department of Health and Human Services (HHS) implemented a Medicare prospective payment system (using data based on medical practices and costs in 1981) that pays hospitals predetermined fixed rates based on a patient's medical condition. GAO reviewed the 1981 data and how changes in medical practices and costs since that time may have affected prospective payment rates for cardiac pacemaker surgeries. The information GAO obtained from 12 hospitals and 4 major pacemaker manufacturers showed that the data used to compute the payment rates (1) contained errors that could affect the rates reasonableness; (2) were collected at a time when hospitals had little incentive to take full advantage of purchasing efficiencies or warranty benefits; and (3) do not reflect the more recent shift toward the use of higher cost, more technologically advanced pacemakers.
Document Details
- Document Type
- Technical Report
- Publication Date
- Feb 26, 1985
- Accession Number
- ADA157798
Entities
Organizations
- United States Government Accountability Office