Obamacare acting administrator Slavitt nominated to head agency

The Centers for Medicare & Medicaid Services announced a new approach to paying for joint replacement for Medicare patients on Thursday.

Groups representing hospitals and doctors said they were pleased by Slavitt’s nomination. However, the hospital would be held accountable for the quality and costs of care for the entire episode – from the time of the surgery through 90 days after discharge.

The federal Centers for Medicare and Medicaid Services, in response to CPI’s story, said, “Reducing improper payments in Medicare Advantage is a top priority for CMS”.

Mary Wakefield, the acting deputy secretary of the Department of Health and Human Services, was nominated to be confirmed in her position.

The proposed 5-year payment model would apply to 75 regions across the country and almost all hospitals in those areas would be required to participate.

The agency is seeking public comment until September 8 and if the proposal is finalized, it would begin January 1 and last for five years.

The most frequent procedures among Medicare beneficiaries are hip and knee replacements.

The quality and cost of these surgeries vary greatly.

“For instance, the rate of complications like infections or implant failures after surgery can be more than three times higher at some facilities than others, increasing the chances that the patient may be re-admitted to the hospital”, the agency said.

The low-key White House announcement of a nomination for one of the most important jobs in the Obama administration prompted one knowledgeable Senate source to suggest that neither McConnell nor Hatch’s committee will be in any hurry to take up the Slavitt issue.

The hospitals involved in the experiment would continue to be paid under existing Medicare payment systems.

Depending on the quality, the hospital may receive an additional payment or have to pay Medicare. Officials also plan to survey patients about their experience.

The goal is to create a more consistent level of care, CMS said.

“But, it is a demonstration, that is yet to be tested – particularly on such a large scale”, she said.