Archive for Medicare post-acute care

 

For Nursing Homes, Medicare Giveth and Medicare Taketh Away

Nearly 4000 skilled nursing facilities will receive bonuses from Medicare this year while nearly 11,000 will be penalized under Medicare’s Skilled Nursing Facility Value-Based Purchasing Program.

The program, created in 2014, rewards nursing homes that keep low the number of patients who must be admitted to hospitals during the year and penalizes those with the highest hospital admission rates.

Successful nursing homes will receive bonuses of as much as 1.6 percent for each Medicare patient they serve while those that had too many hospital admissions will face penalties of nearly two percent for all of their Medicare patients.

On the whole, non-profit and government-owned nursing homes fared better than for-profit facilities.  More than half of all nursing homes in Alaska, Hawaii, and Washington state will receive bonuses while 85 percent of those in Arkansas, Louisiana, and Mississippi will be penalized.

Learn more about Medicare’s Skilled Nursing Facility Value-Based Purchasing Program and its impact on nursing homes in this Kaiser Health News report.

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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 November agenda were:

  • MedPAC’s mandated report on long-term care hospitals
  • patient functional assessment data used in Medicare payment and quality measurement
  • modifying advanced alternative payment model (A-APM) payments
  • modifying the Medicare-dependent hospital program
  • promoting greater Medicare-Medicaid integration in dual-eligible special-needs plans
  • the Medicare Advantage quality bonus program
  • Medicare Advantage encounter data

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.…

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.

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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.

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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.…