The non-partisan legislative branch agency that advises Congress and the administration on Medicare payment policies has submitted its mandatory annual report to Congress.
Among the findings included in the report by the Medicare Payment Advisory Commission are:
- Medicare’s hospital readmissions reduction program has not resulted in increases in emergency room visits or hospital observation stays.
- Many Medicare accountable care organizations, while maintaining or improving quality, are producing more modest savings than predicted.
- MedPAC approves of Medicare’s proposals to redesign the case-mix classification system for skilled nursing facilities.
- MedPAC supports changes Medicare has proposed for patient assessment and therapy requirements for skilled nursing facilities.
MedPAC’s recommendations include:
- Authorizing outpatient-only hospitals in isolated rural communities to ensure access to emergency care.
- Reducing payments to off-campus emergency departments in certain urban areas.
- Rebalancing Medicare’s physician fee schedule to increase payments for ambulatory evaluation and management services while reducing payments for procedures, imaging, and tests.
- Paying for sequential stays in a unified prospective payment system for post-acute care.
- Establishing new ways to help patients, families, and hospitals identify higher-quality post-acute care providers for their patients.
- Establishing new principles for measuring quality that address both population-based measures and quality incentives.
- Encouraging the development of managed care plans that better meet the needs of the dually eligible (Medicare and Medicaid) population.
- Eliminating Medicare payment increases for skilled nursing facilities in FY 2019 and FY 2020 because of the healthy financial condition of those facilities.
- Urging Medicare to use a uniform set of population-based measures for different health care settings and different populations.
- Moving forward with a unified post-acute-care payment system as quickly as possible.
Learn more about MedPAC’s thinking, research, conclusions, and recommendations by consulting the following materials: the news release that accompanied MedPAC’s transmission of its report to Congress; a fact sheet that accompanied the report’s release; and the 407-page report itself.