Medicare post-acute care

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s April agenda were: Expanding the use of value-based payment in Medicare Medicare Shared Savings Program performance Redesigning the Medicare Advantage quality bonus program Increasing the accuracy and completeness of Medicare Advantage encounter data Evaluating patient functional assessment data reported by post-acute-care providers Options for slowing the growth of Medicare fee-for-service spending for emergency department services Options to increase the affordability of specialty drugs and biologics in Medicare Part D Improving payment for low-volume and isolated outpatient dialysis [...]

Mixed Verdict: Home Health Leads to More Readmissions But Lower Costs

Readmission rates are greater for patients discharged from hospitals to home health care than they are for those discharged to skilled nursing facilities but home health services cost so much less than nursing homes that home health saves money even with the higher numbers of hospital readmissions. This is one of the major findings of a new study comparing differences in outcomes for patients who are admitted to skilled nursing facilities upon discharge from the hospital to those for patients who go direct home and receive home health services. The study also found no meaningful differences in patient mortality or [...]

MedPAC Offers Recommendations on FY 2020 Rates, More

Last week the Medicare Payment Advisory Commission released its annual report to Congress.  Included in this report are MedPAC’s Medicare rate recommendations for the coming year.  They are: hospital inpatient rates – a two percent increase hospital outpatient rates – a two percent increase physician and other health professional services rates – no update skilled nursing facilities – no 2020 increase home health agencies – a five percent rate reduction inpatient rehabilitation facilities – a five percent rate reduction long-term-care hospital services – a two percent increase hospice services – a two percent rate reduction MedPAC also recommended that the [...]

MedPAC Debates Post-Acute Payments

As the Centers for Medicare & Medicaid Services continues to develop a unified payment system for all post-acute-care providers, Congress’s advisors on Medicare payment policy appear ready to weigh in on an important aspect of such a system: Whether payments should be based on entire episodes of care or individual stays in post-acute-care facilities. And at least for now, the Medicare Payment Advisory Commission is leaning toward recommending that post-acute-care payments be based on individual stays. At their March public meeting, MedPAC commissioners expressed concern that post-acute-care payments based on entire episodes of care might create financial incentives for providers [...]

2019-03-13T14:55:27-04:00March 13, 2019|Medicare post-acute care, MedPAC|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s March agenda were: two Medicare payment strategies to improve price competition and value for Part B drugs: reference pricing and binding arbitration options for slowing the growth of Medicare fee-for-service spending for emergency department service. Medicare’s role in the supply of primary care physicians evaluating an episode-based payment system for post-acute care mandated report: changes in post-acute and hospice care following the implementation of the long-term care hospital dual payment rate structure MedPAC is an independent congressional [...]

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s December agenda were: The Medicare prescription drug program (Part D) Opioids and alternatives in hospital settings: payments, incentives, and Medicare data Hospital inpatient and outpatient services payments Redesigning Medicare’s hospital quality incentive programs Physicians and other health professional services payments Medicare payment policies for advanced practice registered nurses and physician assistants Ambulatory surgical centers and hospice payments Skilled nursing facilities, home health agency, and inpatient rehabilitation facilities payments Long-term care hospital services payments Outpatient dialysis payments Future [...]

For Nursing Homes, Medicare Giveth and Medicare Taketh Away

Nearly 4000 skilled nursing facilities will receive bonuses from Medicare this year while nearly 11,000 will be penalized under Medicare’s Skilled Nursing Facility Value-Based Purchasing Program. The program, created in 2014, rewards nursing homes that keep low the number of patients who must be admitted to hospitals during the year and penalizes those with the highest hospital admission rates. Successful nursing homes will receive bonuses of as much as 1.6 percent for each Medicare patient they serve while those that had too many hospital admissions will face penalties of nearly two percent for all of their Medicare patients. On the [...]

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s November agenda were: MedPAC’s mandated report on long-term care hospitals patient functional assessment data used in Medicare payment and quality measurement modifying advanced alternative payment model (A-APM) payments modifying the Medicare-dependent hospital program promoting greater Medicare-Medicaid integration in dual-eligible special-needs plans the Medicare Advantage quality bonus program Medicare Advantage encounter data MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the [...]

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s October agenda were: managing prescription opioid use in Medicare Part D opioids and alternatives in hospital settings: payments, incentives, and Medicare data Medicare payment policies for advanced practice registered nurses and physicians Medicare’s role in the supply of primary care physicians Medicare payments for services provided in inpatient psychiatric facilities episode-based payments and outcome measures under a unified payment system for post-acute care Medicare policy issues related to non-urgent and emergency care MedPAC is an independent congressional [...]

CMS: More Medicare Site-Neutral Payments Coming

The federal government is unlikely to stop with outpatient visits in its drive to make more Medicare payments on a site-neutral basis. That was the message Centers for Medicare & Medicaid Services administrator Seema Verma delivered at a public event last week. We are taking a look at [site-neutral payments] across the board and looking at our authority and where we can weigh in on it.  But I think the post-acute space is something where there are a lot of differentials in payments and something we’re very interested in exploring. CMS recently proposed extending its use of site-neutral payments for [...]

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