ppt课件-lindsaybockstedt,ph.d.director,globalhealthpolicy.pptVIP

* * Currently in the US, our payment systems are siloed by provider type and not tied to value. These payment systems have a lot of momentum and our therapies have fared well/ Big issue on DRGs has been rebalancing them away from surgical care and toward medical care. Concern about excess profitability of surgical procedures and potential overuse. Physician payments have been stable but the Fee-for-service system has been crumbling financially and criticized for rewarding quantity not quality. Widely held concerns that payments need to be rebalanced away from specialty, procedure driven care and towards primary care. We saw drastic steps toward this in the recently released rule for 2010. * * * * * * * * * * * Explain the EV Framework * * * * National Average Medicare Physician Payment Rates for Significant Medtronic Therapies Therapy/CPT Code CY2007 CY2008 CY2009 CY2010 CY2011 CY2012 CY07-12 ICDs (33249) $878 $886 $919 $962 $963 $963 + 9.68% Pacemakers (33208) $485 $512 $532 $554 $556 $556 + 14.64% DES (92980) $796 $806 $848 $818 $873 $873 + 9.67% AAA (34802) $1,252 $1,226 $1,261 $1,318 $1,338 $1,311 + 4.50% Lumbar Fusion (22630) $1,433 $1,413 $1,433 $1,459 $1,536 $1,549 +8.09% Cervical Fusion (22554) $1,221 $1,196 $1,200 $1,205 $1,270 $1,281 + 5.78% Kinetra/DBS (61886) $670 $685 $720 $764 $825 $848 + 26.57% Diabetes/CGM (95251) $38 $38 $40 $41 $42 $42 + 10.53% Heart Valves (33405) $2,272 $2,221 $2,282 $2,363 $2,409 $2,369 + 4.27% PHYSICIAN PAYMENT HAS BEEN MORE TURBULENT BUT STILL RELATIVELY STABLE FOR MEDTRONIC THERAPIES WHY ARE ADDITIONAL PAYMENTS OPTIONS IMPORTANT FOR NEW TECHNOLOGIES? Prospective payment systems often do not adequately account for new technologies Hospitals are provided a fixed, prospectively determined payment Typically, technologies are introduced without any changes to the PPS classifications or payments, leaving hospitals at risk for higher costs associated with new technologies Annual PPS updates are generally based on