GJ Medicare payments near bottom, study says

Grand Junction might get plaudits from national organizations looking for better ways to provide health care, but it has yet to pay off in the pocketbook for practitioners.

Physicians, hospitals and other providers in the Grand Junction region are reimbursed by Medicare at lesser rates than their peers around most of the country, according to a study released Tuesday.

The conclusion to draw from the findings, said an author of a Dartmouth Atlas study of Medicare reimbursements around the nation, is that Grand Junction’s progress has not been financially rewarded.

“It’s fair to say in a world of fee-for-service health care in which Medicare care pays for what you do, that a system that delivers high quality but conservative care is going to be penalized financially,” said Jonathan Skinner, John Sloan Dickey Third Century Chair of Economics at Dartmouth College.

In the Grand Junction hospital-referral region from 2003 to 2008, the latter being the most recent year for which numbers were available, Medicare reimbursed physicians at 56.5 percent of the national average, according to the study.

That placed Grand Junction at the bottom for Medicare reimbursement in Colorado, which overall saw reimbursements of 87 percent of the national average.

The study, which follows on the heels of a study that three years ago drew national attention to the Grand Junction area and the various nonprofit organizations that are part of the health care system, studied a larger sample of Medicare patients, 20 percent instead of the previous 5 percent.

One thing didn’t change: Medicare reimbursements in Grand Junction remained markedly below most of the rest of the country.

Even after price adjustment to take in different costs in various parts of the country, “There remains a remarkable gap between price-adjusted Medicare reimbursements per beneficiary in (hospital referral regions) such as Miami and Grand Junction,” the study said.

In one sense, Skinner said, the report illustrates there remains plenty of room for improvement in health care.

“One of the objectives of health care reform was an attempt, a way to send more money basically to places like Grand Junction, which were doing a good job to begin with,” Skinner said.

The Grand Junction approach hasn’t resulted necessarily in significantly lower income for physicians, said Dr. Gregory Reicks, president of the Mesa County Physicians Independent Practice Association. The focus on Grand Junction brought attention to the region, which had some spinoff benefits, such as a $12 million Beacon grant to demonstrate how costs can be reduced and patient care improved through collection, analysis and sharing of clinical data, as well as the redesign of primary-care practices and clinics, Reicks said.

“We’ve been able to get quite a bit of input” with policy makers and politicians and seen some suggestions incorporated into health care reform, Reicks said.

Medicare provides health insurance to 47 million elderly and disabled individuals and is the largest single payer of health care services in the country, paying out an estimated $500 billion in 2010, according to the Congressional Budget Office.



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