One of the very few and somewhat mysterious successes in health care this year was recently chronicled by Lori Montgomery in an article in The Washington Post describing the substantial drop in the growth of Part B Medicare costs in 2011. Although these costs usually grow by 4% a year or more, they are now growing at a mere 2%. Everyone she interviewed about this was baffled. She writes:

“At first, chief Medicare actuary Rick Foster thought it was a mistake, perhaps a glitch in data collection. No other explanation made sense. Congress had just passed far-reaching health-care legislation that mandated cuts in Medicare spending. But the law was so new that rules for implementation had not been written.”

Montgomery goes on to interview a host of people who couldn't explain it. Some speculated that it is the recession. Others (Democrat politicians) thought it is the salutary effect of Obama's health care law. Still others argued that this shows how efficient the Medicare program is.

I think this is mainly related to the rising co-pay costs for Medicare beneficiaries. Folks are worried about paying their 20% of most services, and are delaying care and not picking up their meds as often as before. We know that’s true. Quest Diagnostics, for example, notes that more patients than ever are not pursuing their ordered lab tests (with co-pays attached) their physicians order, just to save money. This is not a good sign in terms of preventing preventable admissions and complications. But, it’s the result of the Great Recession’s impact on middle class beneficiaries.

For more information about Medicare physician payment, visit the physician payment issues section on CardioSource.org. Also check out the Payment Innovations Community.