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

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.…

The Medicare Payment Advisory Commission, which advises Congress on Medicare payment issues, met last week in Washington, D.C.

Among the issues on MedPAC’s agenda were:

• paying for sequential stays in a unified Medicare payment system for post-acute care
• encouraging Medicare beneficiaries to use higher-quality post-acute care providers
• using payment policy to ensure appropriate access to and use of hospital emergency department services
• the Centers for Medicare & Medicaid Services’ financial alignment demonstration for dual-eligible beneficiaries
• the effectiveness of the Medicare hospital readmissions reduction program
• population-based quality measures such as preventable admissions and home and community days

Go here, to MedPAC’s web site, to see the issue briefs and presentations that supported the discussion of these issues.

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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.…

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.…