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Medicare Watch

Your Weekly Medicare Consumer Advocacy Update

Many Beneficiaries Unaware of Available Information on Physician Quality

May 15, 2014

New Study Highlights Limited Beneficiary Awareness of Physician Quality Information

The Medicare and Medicaid Research Review (MMRR) recently released a study on what influences Medicare beneficiary awareness of physician quality information. Physician quality information can be used by beneficiaries to find physicians in their area who provide high-quality care. This indirectly creates an incentive for physicians to improve the quality of care they provide. Overall, the study found low rates of awareness of this quality information (around 13 percent). Certain population characteristics—such as age, race, education, and self-reported health status—affect this rate, but only to a slight degree. To drastically increase awareness, the study concludes that Medicare would need to conduct a broad-based outreach campaign.

The study focuses on Medicare beneficiaries who are 65 or older and have one or more chronic illness. It found that older, non-white, and more educated respondents were more aware of physician quality information. Additionally, those who reported poorer health or more chronic conditions were more likely to be aware of the information. Awareness was significantly influenced by geographic location, possibly because some areas more aggressively promote the availability of physician quality information.

The recent increase in the availability of health quality information as required by the Affordable Care Act, such as the Medicare physician compare website (http://www.medicare.gov/physiciancompare), may help increase awareness of health quality information. The study also suggests that an increased level of awareness is not completely necessary to encourage physicians to improve quality of care—simply making this information available to consumers may be enough.

Click here to read the MMRR study.

Hospital Quality Improving, Readmissions Falling for People with Medicare

According to new data released by the Department of Health and Human Services (HHS), hospitals around the country are becoming safer places. Incidents occurring in hospitals such as adverse drug reactions, falls and infections decreased 9 percent during 2011 and 2012. As a result, nearly 15,000 deaths and 560,000 patient injuries were prevented and about $4 billion was saved in health spending.

Additionally, hospital 30-day readmission rates for people with Medicare decreased 8 percent since 2011. Because of the Affordable Care Act, collaboration between public and private entities is now easier—allowing for the proliferation of best practices to further reduce unfavorable hospital incidents.

Read the HHS announcement.

Volume 5, Issue 19

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Medicare Reminder

If you have Original Medicare, Part A determines coverage and costs of inpatient hospital care and skilled nursing facility care based on benefit periods. A benefit period begins the day you enter a hospital and ends when you have not received inpatient hospital or Medicare-covered skilled care in a SNF for 60 days in a row.

If you go into the hospital or SNF after one benefit period has ended (more than 60 days after you left), a new benefit period begins. You must pay the Part A deductible for each benefit period ($1,216 in 2014). There is no limit to the number of benefit periods you can have or to the length of an individual benefit period.

For example, if enter the hospital as an inpatient on May 1st and go home on May 15th (14 days in the hospital), but you need to go back into the hospital on June 30th (after 46 days out of the hospital), you are still in the same benefit period. You do not have to pay another hospital deductible.

If you have a Medicare Advantage plan, it may have different rules for how it covers hospital and skilled nursing facility care. Contact your plan to learn more.

Click here to learn more about how Medicare covers inpatient hospital services on Medicare Interactive.

Click here to learn more about how Medicare covers skilled nursing facility care on Medicare Interactive.

 

Spotlight

May is “Older Americans Month”—a time for people across the country to celebrate the older adults in their lives and honor the contributions they have made to their families, friends and communities.

This month, the Administration for Community Living (ACL) is celebrating Older Americans month with the theme, Safe Today. Healthy Tomorrow—focusing on safety and spreading awareness of the ways older adults can stay healthy and live longer.

Visit ACL’s website to see how you can celebrate Older Americans Month.

 

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