Archive for Medicare post-acute care


MedPAC Meets

Last week the Medicare Payment Advisory Commission held two days of public meetings in Washington, D.C.

During the sessions MedPAC, a non-partisan legislative branch agency that advises Congress on Medicare payment issues, addressed the following subjects:

  • a Medicare Advantage status report
  • a Medicare prescription drug program (Part D) status report
  • hospital inpatient and outpatient payments
  • physician payments
  • ambulatory surgical center, dialysis center, and hospice payments
  • post-acute care facility payments
  • the hospital readmissions reduction program
  • telehealth
  • accountable care organizations

Go here to see the issue briefs and presentations used during the meetings.…

CMS Nursing Home Program Cuts Hospital Admissions

An experimental Medicare program has helped nursing homes reduce the frequency with which their residents are admitted to hospitals.

The Centers for Medicare & Medicaid Services’ Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents has reduced avoidable hospitalizations among nursing facility residents 17 percent in the program’s three years.

143 nursing homes in seven states participated in the program, which employed third-party vendors, known as enhanced care and coordination providers, to provide education to nursing facility staff.

Hospitals, too, can benefit from the program because it may help reduce avoidable hospital readmissions for which they are penalized financially by Medicare.

In the second phase of the program, which began this year, nursing homes are paid Medicare rates to serve patients with any of six medical conditions for which those individuals might otherwise be hospitalized.

Learn more about the program and the results it has produced in this final report on the program’s first three years.…

MedPAC to CMS: Speed Up Move to New Post-Acute Payment System

Medicare should adopt a unified system for post-acute-care payments even earlier than its target date of 2024.

Or so the Medicare Payment Advisory Commission told Congress.

MedPAC’s idea?  Implement such a system by 2021 and phase it in over a three-year transition period, the agency said in its annual report and recommendations to Congress

Learn more about what MedPAC recommended and why it recommended it in this McKnight’s Long-Term Care News article.  Find MedPAC’s annual report to Congress here.…

MedPAC Delivers Annual Report to Congress

The Medicare Payment Advisory Commission has issued its annual report and recommendations to Congress.

The major issues addressed in the report include:

  • implementing a unified payment system for post-acute care
  • reforming Medicare payment for drugs under Part B
  • redesigning the merit-based incentive payment system (MIPS) and strengthening advanced alternative payment models
  • using premium support for Medicare
  • the relationship between clinician services and other Medicare services
  • payments from drug and device manufacturers to physicians and teaching hospitals in 2015
  • the medical device industry
  • stand-alone emergency departments
  • hospital and skilled nursing facility use by Medicare beneficiaries who reside in nursing facilities
  • the role of Medicare policy in provider consolidation

To learn more about MedPAC’s annual report to Congress, see this MedPAC news release, this fact sheet, and the report itself.


MedPAC Testifies Before Congress

Last week Mark Miller, executive director of the Medicare Payment Advisory Commission, testified before the House Ways and Means Committee’s Health Subcommittee.

In his testimony, Miller summarized and explained some of the key points MedPAC made in its March report to Congress, including:

  • why MedPAC believes most post-acute-care payments are too high;
  • why Medicare needs to reduce the incentives for hospitals and doctors to deliver more services;
  • why it recommended no FY 2018 payment increases for long-term acute-care hospitals, ambulatory surgical centers, and skilled nursing facilities and reductions of payments for home health care providers and inpatient rehabilitation facilities;
  • why Congress should not be concerned about hospitals’ negative Medicare margins;
  • why new steps are needed to evaluate the performance and adequacy of payments to free-standing emergency rooms and ambulatory surgical faculties;
  • why current payments to ambulatory surgical centers, outpatient dialysis facilities, and physicians are adequate; and
  • more.

Miller also chastised federal officials for not embracing MedPAC’s recommendations sooner, saying that adopting those regulations would have saved Medicare billions of dollars.

MedPAC is an independent agency that advises Congress on Medicare payment issues.  While its recommendations are binding neither on Congress nor the administration, its views are highly influential and often …