CCH® Medicare — 12/31/08
Health industry facing many issues in 2009, study says
The health industry will face many challenges in 2009, including dealing with
more underinsured, documenting performance, and adapting to new coding and
payment methods, according to research published by the Health Research Institute
at PricewaterhouseCoopers (PwC), New York, New York.
The coming year will be a watershed for healthcare in the United States,
said David Chin, PwC Health Research Institute leader. President-elect
[Barack] Obama has called for significant reform for healthcare and will have
a Democratic Congress supporting him, he said. According to the PwC
Health Research Institute, in 2009:
- Hospitals and other providers will experience an increase in bad debt and
a drop in elective procedures as the payer mix continues to shift away from
relatively lucrative commercial insurers.
- The number of underinsured will continue to rise. An estimated 25 million
adults qualify as underinsured, an increase of 60 percent since 2003.
- Health care providers will be penalized for underperformance. CMS has proposed
adding a new index — the total performance score — as part of
Medicare's move to value-based purchasing. If Congress approves, CMS
would replace the current quality reporting system with one in which Medicare
withholds between two percent and five percent of its reimbursements to hospitals.
- Health care organizations will begin the conversion to a new International
Classification of Disease code sets, known as ICD-10. The federal government
has proposed an accelerated timetable for increasing the number of code sets
used for billing and clinical classifications from 17,000 to 150,000. In addition
to clinical process changes, the entire healthcare system — from quality
of care, to medical records, to incentive salary systems, to reimbursement —
will have to be adapted.
A full copy of PwCs' Health Research Institute's Top Nine
Health Industry Issues in 2009 is available online at www.pwc.com/hri/top9.
Source: CCH Washington Bureau, Dec. 29, 2008.
For more information on this and related topics, consult the CCH® Medicare and Medicaid
Guide.
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