Archive for Medicare 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 October agenda were:

  • managing prescription opioid use in Medicare Part D
  • opioids and alternatives in hospital settings: payments, incentives, and Medicare data
  • Medicare payment policies for advanced practice registered nurses and physicians
  • Medicare’s role in the supply of primary care physicians
  • Medicare payments for services provided in inpatient psychiatric facilities
  • episode-based payments and outcome measures under a unified payment system for post-acute care
  • Medicare policy issues related to non-urgent and emergency care

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.


CMS: More Medicare Site-Neutral Payments Coming

The federal government is unlikely to stop with outpatient visits in its drive to make more Medicare payments on a site-neutral basis.

That was the message Centers for Medicare & Medicaid Services administrator Seema Verma delivered at a public event last week.

We are taking a look at [site-neutral payments] across the board and looking at our authority and where we can weigh in on it.  But I think the post-acute space is something where there are a lot of differentials in payments and something we’re very interested in exploring.

CMS recently proposed extending its use of site-neutral payments for Medicare-covered outpatient services and the Medicare Payment Advisory Commission (MedPAC) has recommended that CMS pursue site-neutral payments among the different types of post-acute-care providers.

Learn more about Verma’s remarks and CMS’s intentions in this Fierce Healthcare article.


Nursing Home Occupancy Declines

Nursing home occupancy fell to 81.7 percent during the second quarter of 2018, according to the National Investment Center for Seniors House & Care.

Among the reasons for this decline in the use of skilled nursing facilities are policy changes that seek to shorten length of stay and competition from home health services and assisted living facilities.

Occupancy among seniors enrolled in Medicare Advantage plans has been flat, with those living in urban areas more than twice as likely to spend time in skilled nursing facilities than those who reside in rural areas.

Learn more about this latest trend in skilled nursing facility occupancy from this report from the National Investment Center for Seniors House & Care.…

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:

  • a unified payment system for post-acute care
  • long-term-care hospitals
  • physician payments
  • next steps in redesigning Medicare’s hospital quality and value programs

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.…

Ways and Means Praises CMS for Red Tape Efforts, Seeks More

Leaders of the House Ways and Means Committee have written to Centers for Medicare & Medicaid Services administrator Seema Verma to praise her agency’s work in eliminating Medicare red tape – but also asking her to “…take further steps to improve patient care by alleviating administrative and regulatory burdens for Medicare providers.”

In three separate letters, committee chairman Kevin Brady (R-TX) and Health Subcommittee chairman Peter Roskam (R-IL) expressed their pleasure with CMS’s recent efforts but specified areas where they would like to see further action.

For hospitals, they wrote that they seek further red-tape cutting in the areas of Medicare conditions of participation, facility co-location, hospital quality star ratings, and meaningful measures.

For post-acute-care providers, they want CMS to address the long-term acute-care hospital 25 percent rule, to hold more inpatient rehabilitation facility open-door forums, and to address skilled nursing facility consolidated billing, documentation to satisfy home health eligibility, and hospice medical review audits.

And for physicians, they urged CMS to continue working to improve the Medicare physician fee schedule, the outpatient prospective payment system, and payments for durable medical equipment and other medical equipment and supplies.

Go here to see the Ways and Means letter addressing hospital issues, …