Medicare post-acute care

MedPAC Issues Annual Report to Congress

The Medicare Payment Advisory Commission has sent its mandatory annual report to Congress. Included in the report are sections on: Beneficiary enrollment in Medicare: eligibility notification, enrollment process, and Part B late enrollment penalties. Restructuring Medicare Part D for the era of specialty drugs. Medicare payment strategies to improve price competition and value for Part B drugs. MedPAC’s mandated report to Congress on clinician payments. Issues in Medicare beneficiaries’ access to primary care. Assessment of the Medicare Shared Savings Program’s effect on Medicare spending. Ensuring the accuracy and completeness of Medicare Advantage encounter data. Redesigning the Medicare Advantage quality bonus [...]

iqtsupport2019-06-19T11:57:26-04:00June 19, 2019|Alternative payment models, Centers for Medicare & Medicaid Services, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Some Readmissions From Nursing Homes to Hospitals Hard to Avoid

Improvements in the delivery of care cannot prevent some skilled nursing facility patients from being readmitted to hospitals, a new study has concluded. According to the study, when advanced practice nurses brought best practices to 16 nursing homes participating in a Medicare pilot program, they enjoyed considerable success reducing hospital readmissions but found themselves unable to stop some, including readmissions caused by residents or their families calling ambulances on their own; patients refusing treatment and then demanding hospitalization because of the effects of the denied treatment; and patients in hospice deciding they want surgery. These were among the findings in [...]

iqtsupport2019-06-07T06:00:44-04:00June 7, 2019|Medicare post-acute care|

Low-Income Patients More Likely to End Up in Low-Quality SNFs

Dually eligible individuals are more likely than others to find themselves in low-rated skilled nursing facilities, recent research has found. According to a study published in the Journal of Applied Gerontology, more than 50 percent of dually eligible individuals – those covered by both Medicare and Medicaid – who are admitted to skilled nursing facilities are served by facilities that have low (one or two stars) ratings under Medicare’s five-star quality rating system for nursing homes. Overall, the dually eligible are 9.7 percentage points more likely than patients not on Medicaid to be served by lower-rated facilities. The education of [...]

iqtsupport2019-04-19T06:00:35-04:00April 19, 2019|Medicaid, Medicare post-acute care, post-acute care|

Feds Looking to Bundle Medicare Post-Acute Payments?

Bring us your ideas for bundling Medicare post-acute-care payments, the head of the Center for Medicare and Medicaid Innovation recently told a gathering of hospital officials in Washington, D.C. As reported by Fierce Healthcare, CMMI director Adam Boehler told hospital officials that Now is the time to bring us ideas. We’re really in listening mode…I think there’s been a lot of intrigue and interest we’ve heard from people. So we’re gathering stakeholder input there on that and it’s a great time to give us thoughts on where we can lower costs. Learn more from the Fierce Healthcare article "CMMI's Adam [...]

iqtsupport2019-04-15T06:00:16-04:00April 15, 2019|Center for Medicare and Medicaid Innovation, CMMI, Medicare, Medicare post-acute care, post-acute care|

SNF Discharge May Affect Hospital Readmission Rates

Heart failure patients discharged from skilled nursing facilities after two days or less may be as much as four times more likely to be readmitted to a hospital than those who stay longer, according to a new analysis. The study also found that the hospital readmission rate falls by half for patients who remain in a skilled nursing facility for one to two weeks. The analysis evaluated Medicare data for heart failure patients at least 65 years old and did not adjust for their severity of illness. These findings suggest that the current emphasis on limiting patients’ time in post-acute-care [...]

iqtsupport2019-04-11T06:00:21-04:00April 11, 2019|Medicare, Medicare post-acute care, 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 [...]

iqtsupport2019-04-09T06:00:04-04:00April 9, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

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 [...]

iqtsupport2019-03-22T06:00:57-04:00March 22, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy|

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 [...]

iqtsupport2019-03-19T06:00:37-04:00March 19, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, Uncategorized|

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 [...]

iqtsupport2019-03-13T14:55:27-04:00March 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 [...]

iqtsupport2019-03-12T06:00:49-04:00March 12, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, post-acute care|