Medicare's Payout for Stroke Lagging Behind Cost

Payment gap could mean cutbacks in quality of care, experts warn

FRIDAY, Feb. 17, 2006 (HealthDay News) -- Future stroke care in the United States may be at risk because Medicare payments aren't keeping pace with the costs for stroke treatment and preventive stroke surgery, a new study finds.

Researchers analyzed data from fiscal year 2002 to determine Medicare's reimbursement for standard treatment of ischemic (clot-linked) stroke and then projected those figures to fiscal year 2005.

"With an average Medicare reimbursement of $6,589, hospitals lost an average of $2,100 to $3,700 for treating stroke," study author Thomas Goss, vice president for consulting services at Covance Market Access Services Inc., said in a prepared statement.

The study concluded that stroke patients' hospital stays would have to be reduced almost by half to bring standard stroke care in line with Medicare's reimbursement for stroke treatment.

"To reduce costs by further decreasing length of stays appears inconsistent with current standards for stroke care," Goss said.

His team presented the findings Friday at the American Stroke Association's annual stroke conference, in Kissimmeee, Fla.

About 72 percent of acute stroke patients in the United States are Medicare beneficiaries. An estimated 700,000 Americans suffer a new or recurrent stroke each year and 88 percent of those are ischemic stroke, caused by a blockage in an artery that supplies blood to the brain.

"Without adequate reimbursement for these cases, it may be hard for hospitals to adopt new technologies such as intravenous thrombolysis and other therapies that may be in development to treat stroke," study co-author Dr. David Matchar, a professor of medicine at Duke University, said in a prepared statement.

This study was funded by pharmaceutical company AstraZeneca.

More information

The Society of Interventional Radiology has more about stroke prevention and treatment.

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