Final Medicare Payment Changes Still Benign For Device Cos
August 03 2009 - 10:13AM
Dow Jones News
Final changes to Medicare hospital-reimbursement levels for the
upcoming U.S. fiscal year appear slightly improved compared with a
generally benign earlier proposal, suggesting the system won't
create headaches for medical-device companies in the near term.
Many pricey devices such as implantable defibrillators and heart
stents are sold to hospitals, which often recoup their costs from
Medicare payments tied to various types of procedures. While the
link between Medicare payments and device prices is tenuous, the
annual Medicare changes are still watched closely for clues to
potential pricing trends for companies such as Medtronic Inc.
(MDT), Boston Scientific Corp. (BSX) and Johnson & Johnson
(JNJ).
The scrutiny is particularly strong as investors and analysts
speculate on what health-care reform could mean for device
companies, and whether hospitals that feel squeezed by the
government will pinch device prices as a result.
For the fiscal year starting in October, at least, the Medicare
system that sets reimbursement rates doesn't look like a major
source of that pressure.
Wells Fargo analyst Larry Biegelsen described the final rule
from the Centers for Medicare & Medicaid Services as
"positive," while JPMorgan's Michael Weinstein called it "a little
good news from D.C."
The Medicare report was issued late Friday. Stocks early Monday
were mostly up amid small changes for some big device companies
including Medtronic, Boston Scientific, heart-device maker St. Jude
Medical Inc. (STJ) and orthopedics firms Zimmer Holdings Inc. (ZMH)
and Stryker Corp. (SYK).
Analysts described the final rule from CMS, which appeared to
bump up reimbursement levels for some devices, as modestly improved
compared with April's proposal. The final version also postponed a
plan to hit hospitals with an adjustment triggered by hospitals
wringing money out of a newer system that ties payments to the
severity of patients' condition.
Analyst Weinstein calculated reimbursement improvements for
drug-coated heart stents and implantable defibrillators, and he and
other analysts pointed to favorable reimbursement adjustments for
orthopedic devices such as replacement joints and spinal
implants.
Weinstein said that higher payment rates across most categories
are unlikely to be passed through to device makers "in any
significant way," but will instead help hospital profitability. He
also noted that movements in device prices and Medicare payment
rates aren't tightly correlated.
"Still, we view this as a positive outcome for the MedTech
group, particularly in an environment when favorable news from
Washington has been increasingly harder to come by," Weinstein
said.
Overall, CMS on Friday said that acute-care hospitals will
receive an inflation update of 2.1% in their payment rates for
fiscal 2010.
The proposal in April to start making adjustments in the coming
year to recoup excess spending linked to the shift to
severity-based payments would have nearly offset the inflation
update. But CMS said it decided not to implement an adjustment
until it has a full year of fiscal 2009 data. The agency will
consider phasing in future adjustments over an extended period
starting in fiscal 2011.
-By Jon Kamp, Dow Jones Newswires; 617-654-6728;
jon.kamp@dowjones.com