Federal officials for more than a decade have let hospitals charge Medicare varying rates for certain emergency department overhead and staffing costs called facility fees-a controversial policy some critics believe invites overcharges.
Federal officials for more than a decade have let hospitals charge Medicare varying rates for certain emergency department overhead and staffing costs called “facility” fees—a controversial policy some critics believe invites overcharges.
Now, in a major turnabout, the CMS has proposed tighter controls over facility fees as part of a plan to redirect billions of dollars Medicare spends annually on outpatient care. Its proposal, though preliminary, is already drawing fire.
CMS officials want to replace five escalating price codes hospitals can choose from in billing facility fees with one flat rate, starting next year. The 2013 rates for ED facility fees start at $51.82 for a Level 1 patient visit and move up to $344.71 at the top range. For 2014, the CMS is proposing a new flat rate of $212.90 for ED visits, regardless of how intensive the treatment is. Doctor fees aren't affected.
Read the full story here: http://bit.ly/15LGZYg
Source: Modern Healthcare
Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending
August 19th 2025Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
Read More