Happy New Year!

Start making some resolutions as 2009 could be a tough year to handle. I expect a lot of change. As the tectonic plates of the healthcare system shift it is up to us whether we can take advantage of it or fall through those gigantic cracks. Since this millennium has started we have seen a tech crash, a real estate crash, and a financial crash. When the dust settles, however, the ones who survive will only be stronger and help us lead in the future. I wish you all the best and hope that this year positions you for that successful journey.

Gorback's Thought's by Michael Gorback MD

Are you kidding me? Hospital services will get "the full rate of inflation" and we get -- maybe (they are "mulling" over it) -- 1.1%? They really do consider us impotent pond scum.

Modern Healthcare, December 5, 2008:

The Medicare Payment Advisory Commission has drafted recommendations to increase payment rates for inpatient and outpatient services at the full rate of inflation in 2010, concurrent with the implementation of a quality incentives program.

Although the draft didn't provide a specific increase for hospitals, the projected marketbasket update in 2010 for hospitals is 2.7 percent, reported Modern Healthcare. MedPAC revisited a proposal it has been trying to get Congress to approve for the past several years: to reduce the indirect medical education (IME) adjustment by 1 percentage point to help finance the quality incentives program for hospitals, Modern Healthcare noted. On other payment issues, the commission mulled over a draft recommendation to increase Medicare physician payments by 1.1 percent in 2010, the same increase doctors will receive in 2009, while commissioners also discussed options to make positive payment updates for ambulatory surgery centers contingent upon the submission of cost data to HHS, Modern Healthcare added. The draft recommendations will be voted on in January.

And then in the same issue, turn the other cheek. . . so we can slap you from the other side.

Medicare Advantage plans are expected to get paid 14 percent more than traditional fee-for-service in 2009, a slight uptick from 2008, according to new data released at the Medicare Payment Advisory Commission's December meeting. At least 9.9 million beneficiaries were enrolled in Medicare Advantage plans this year, a 16 percent increase from 2007, while it is estimated that Advantage plans were paid 13 percent more than traditional fee-for-service Medicare in 2008, reported Modern Healthcare. Among the various Advantage plan types, the controversial private fee-for- service plans will be getting paid 18 percent more than traditional Medicare next year, Modern Healthcare added.