Variations in Medicare Reimbursements

Junior (College 3rd year) ・Healthcare&Medicine ・APA ・3 Sources

Many health care systems in the world are struggling with the variation issues affecting the diverse Medicare reimbursements (Stuart, 2006). These variation issues include fragmented care, lack of coordination, variable quality, and the rapid-growing costs. These variations always affect Medicare reimbursements and results to adverse effects such as patients paying more for the healthcare services, restricted services, and physicians facing lower incomes (Stuart, 2006). Also, the healthcare systems in the world have not been able to maintain a sustainable growth in their market share. They have also been unable to improve the outcomes of the patients.
According to the Dartmouth Atlas Data document, the effects of these variations are well outlined from the data which was pulled out from both the bottom and top of the list by containing adjusted information in price, age, sex, and race (Prigerson, & Maciejewski, 2012). For example, in the County of Florida, the overall Medicare individuals who enrolled based on gender in the year 2012 amounted to a total of 1,965,822 whereby the male enrollees were 885,164 while the women were 1,965,822. On the other hand, the Medicare enrollees based on race the same year in Florida amounted to 1,965,822 out of these, 122,149 being blacks while 1,843,673 being non-blacks. However, in the same county, those below the poverty level amounted to 10% of the total enrollees. The data analysis on the other states such as Kentucky, Hawaii, and Alaska also reflected a huge difference in gender, race, and poverty (Prigerson, & Maciejewski, 2012). Why is this data analysis important? This is a question many of us will like to get answers. The data offers variation issues affecting the Medicare reimbursements meaning that there is a lack of incentive for efficiency in the healthcare system. Besides, it is evident that there is a limited face-to-face interaction between the healthcare providers and the patients. However, these variations always encourage unnecessary healthcare services as well as not reflecting on the quality, value, and patients’ outcomes among others. However, these variations also do not encourage coordination as well as management across the healthcare settings and the healthcare providers (Prigerson, & Maciejewski, 2012). In conclusion, based on my own perspective, the only way of overcoming the variation issues in the healthcare system is by collectively agreeing on the overarching value goal for the healthcare systems so as to be able to improve the relative costs in achieving the positive outcomes (Porter, & Lee, 2013). However, positive outcomes can only be achieved through the formation of a strategic agenda intended for collectively moving to a high-value health care delivery system. This system should comprise of well-organized, integrated practice units, measuring the costs as well as the outcomes for every individual patient, and moving to bundled payments for the cycles of care. The systems should also integrate care delivery across the separate facilities thus expanding excellent services across the geography (Porter, & Lee, 2013).


Porter, M. E., & Lee, T. H. (September 20, 2013). The strategy that will fix health care. Harvard Business Review.

Prigerson, H. G., & Maciejewski, P. K. (January 01, 2012). Dartmouth Atlas: putting end-of-life care on the map but missing psychosocial detail. The Journal of Supportive Oncology, 10, 1.)

Stuart, G. (February 01, 2006). Specialty Hospitals: A Problem Or A Symptom?. Health Affairs, 25, 95.

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