Archive for Medicare

 

MedPAC Mulls Uniform Outcome Measures to Complement Unified Post-Acute Payments

In support of its proposal that Medicare adopt a unified payment system for post-acute-care services, the Medicare Payment Advisory Commission is exploring how to develop uniform outcome measures to support such a new payment system.

Under the MedPAC vision, articulated at its early April public meeting, skilled nursing facilities, home health agencies, long-term-care hospitals, and inpatient rehabilitation facilities would see their outcomes quantified based on their performance on a series of quality measures.

Meanwhile, there has been little congressional interest in the unified post-acute payment proposal so far.  While some aspects of such a proposal could be implemented administratively, the comprehensive system would require legislation.

Learn more about the Medicare uniform outcomes measures proposal, the unified post-acute care payment proposal, how they interact, and the prospects for both from this article in Provider magazine.…

MedPAC Meets

The Medicare Payment Advisory Commission met last week in Washington, D.C. to address a number of Medicare reimbursement-related issues.

Among the subjects on MedPAC’s agenda were:

  • using payments to ensure appropriate access to and use of hospital emergency department services
  • uniform outcome measures for post-acute care
  • applying MedPAC’s principles for measuring quality: hospital quality incentives
  • Medicare coverage policy and use of low-value care
  • long-term issues confronting Medicare accountable care organizations
  • managed care plans for dual-eligible beneficiaries

While MedPAC’s policy and payment recommendations are not binding on Congress or the administration, its views are respected and influential and often become the basis for new public policy.

Go here to see the policy briefs and presentations offered to help guide MedPAC commissioners’ discussions about these and other issues.…

MedPAC Issues 2018 Report to Congress

The Medicare Payment Advisory Commission has issued its 2018 report and recommendations to Congress.

The report includes MedPAC’s recommendations for next year’s Medicare fee-for-service payments; a review of the Medicare Advantage and Medicare Part D programs, with recommendations; and a report telehealth required by the 21st Century Cures Act.

For Medicare fee-for-service rates, MedPAC proposes:

  • the inpatient and outpatient rate increases, physician and other health professional rate increases, and outpatient dialysis increase included under current law
  • no increase for ambulatory surgical centers, long-term-care hospitals, and hospice providers
  • no rate increase for skilled nursing facilities
  • a five percent reduction of payments for home health providers and the introduction of a two-year rebasing of home health rates beginning in 2020
  • a five percent reduction of inpatient rehabilitation facility payments

In addition, MedPAC recommends that Medicare base future payments to post-acute providers on a blend of “each sector’s setting-specific relative weights and the unified post-acute care prospective payments system’s relative weights.”

MedPAC also recommends that Medicare abandon its merit-based incentive payment system (MIPS) in favor of an alternative approach for achieving “the shared goal of high-quality clinician care for beneficiaries in traditional Medicare.”

MedPAC is a non-partisan legislative branch agency that advises …

CMS Reports on Quality Measures Performance

The Centers for Medicare & Medicaid Services has published a new report detailing the progress of health care providers in meeting Medicare quality standards and improving their performance under those standards.

The report, required every three years, focuses on 17 key indicators of quality in the delivery of health care as defined by 247 individual quality measures.

The analysis found that:

  • 670,000 patients improved their control of their blood pressure
  • 510,000 fewer patients have poor control of their diabetes
  • 12,000 fewer people died following hospitalization for a heart attack
  • there were 70,000 fewer unplanned hospital readmissions
  • nursing home residents suffered 840,000 fewer pressure ulcers

In addition, the study reported cost savings associated with better compliance with quality standards, including:

  • $4.2 billion to $26.9 billion saved because of better compliance with medication instructions
  • $2.8 billion to $20 billion saved through fewer treatments for pressure ulcers
  • $6.5 billion to $10.4 billion saved because patients manage their diabetes more effectively

The study also looks hospital and nursing home performance variations based on race and ethnicity, income, sex, urbanicity, region, and age for many quality measures.

Learn more about Medicare’s quality measures and how hospitals and nursing homes are performing under these measures in …

New Report Details Key Health Care Provisions in February Budget Bill

The Congressional Research Service has published a new report describing the health care-related provisions in the Bipartisan Budget Act of 2018 that Congress passed last month to fund the federal government.

A major part of that law was the Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act, and the new report includes descriptions of the Medicare, Medicaid, CHIP, public health, and other health care aspects of the law.

Go here to find the Congressional Research Service report Bipartisan Budget Act of 2018 (P.L. 115-123): Brief Summary of Division E—The Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act.