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 April agenda were:

• Expanding the use of value-based payment in Medicare
• Medicare Shared Savings Program performance
• Redesigning the Medicare Advantage quality bonus program
• Increasing the accuracy and completeness of Medicare Advantage encounter data
• Evaluating patient functional assessment data reported by post-acute-care providers
• Options for slowing the growth of Medicare fee-for-service spending for emergency department services
• Options to increase the affordability of specialty drugs and biologics in Medicare Part D
• Improving payment for low-volume and isolated outpatient dialysis facilities

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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Last week the Medicare Payment Advisory Commission released its annual report to Congress.  Included in this report are MedPAC’s Medicare rate recommendations for the coming year.  They are:

• hospital inpatient rates – a two percent increase
• hospital outpatient rates – a two percent increase
• physician and other health professional services rates – no update
• skilled nursing facilities – no 2020 increase
• home health agencies – a five percent rate reduction
• inpatient rehabilitation facilities – a five percent rate reduction
• long-term-care hospital services – a two percent increase
• hospice services – a two percent rate reduction

MedPAC also recommended that the Centers for Medicare & Medicaid Services replace its current array of hospital quality programs with a new, streamlined “hospital value incentive program,” or HVIP, that would replace the Hospital Inpatient Quality Program, the Hospital Readmissions Reduction Program, the Hospital-Acquired Condition Reduction Program, and the Hospital Value-Based Purchasing Program.

MedPAC’s recommendations are binding on neither the administration nor Congress but its views are highly respected and often find their way into new laws, new policies, and new programs.

Learn more about MedPAC’s annual recommendations to Congress in the full MedPAC report or the MedPAC fact sheet that accompanies the recommendations’ release.…

Members of the Medicare Payment Advisory Commission discussed the possibility of recommending to Congress that it call for national guidelines for how hospitals code emergency department services.

The change may be needed, the commissioners suggested at their March meeting, because hospitals have gravitated toward coding for higher intensity services as time passes.

Such a change, if implemented, could result in less emergency department revenue for some hospitals.

Learn more in the Healthcare Dive article “MedPAC eyes changes to ED coding, Part B drug pricing.”…

As the Centers for Medicare & Medicaid Services continues to develop a unified payment system for all post-acute-care providers, Congress’s advisors on Medicare payment policy appear ready to weigh in on an important aspect of such a system:

Whether payments should be based on entire episodes of care or individual stays in post-acute-care facilities.

And at least for now, the Medicare Payment Advisory Commission is leaning toward recommending that post-acute-care payments be based on individual stays.

At their March public meeting, MedPAC commissioners expressed concern that post-acute-care payments based on entire episodes of care might create financial incentives for providers to discharge their patients prematurely.  Payments based on individual stays pose no such temptation, they believe.

Learn more about the current effort to develop a unified payment system for post-acute care and the challenges that effort faces in addressing both quality and costs in the McKnight’s Long-Term Care News article “Medicare advisors urge Congress against an episode-based payment system for post-acute care.”…

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 March agenda were:

• two Medicare payment strategies to improve price competition and value for Part B drugs: reference pricing and binding arbitration
• options for slowing the growth of Medicare fee-for-service spending for emergency department service.
• Medicare’s role in the supply of primary care physicians
• evaluating an episode-based payment system for post-acute care
• mandated report: changes in post-acute and hospice care following the implementation of the long-term care hospital dual payment rate structure

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.…