Archive for post-acute care

 

CMS Proposes New Medicare Payments for 2021

Medicare will change its provider payments for two types of Medicare-covered services in 2021 and has proposed changes in payments for three other Medicare-covered services in a flurry of activity over the past week.

Last week the Centers for Medicare & Medicaid Services finalized new 2021 Medicare payment rates for:

In addition, this week CMS proposed new 2021 Medicare rates for:

The proposed changes in Medicare provider payments for physician services and outpatient and ambulatory surgical services are subject to a public comment period before they are finalized.…

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 December agenda were:

  • Assessing payment adequacy and updating payments: Physician and other health professional services
  • Assessing payment adequacy and updating payments: Ambulatory surgical center services
  • Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services;
  • Mandated report: Expanding the post-acute care transfer policy to hospice
  • Assessing payment adequacy and updating payments: Skilled nursing facility services
  • Assessing payment adequacy and updating payments: Home health care services
  • Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services
  • Assessing payment adequacy and updating payments: Long-term care hospital services
  • Assessing payment adequacy and updating payments: Outpatient dialysis services
  • Assessing payment adequacy and updating payments: Hospice services
  • The Medicare Advantage program: Status report

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 Weighs in on Proposed Medicare Payment Changes

The Medicare Payment Advisory Commission has submitted formal comments to the Centers for Medicare & Medicaid Services in response to the latter’s publication of a proposed regulation that would govern how Medicare will pay for acute-care hospital inpatient services and long-term hospital care in the coming 2020 fiscal year.

The 14-page MedPAC report addresses four aspects of the proposed Medicare payment regulation:

  • inpatient- and outpatient drug- and device related payment proposals
  • proposed changes in the hospital area wage index
  • the reporting of hospitals’ uncompensated care on the Medicare cost report’s S-10 worksheet
  • the long-term hospital prospective payment system

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.

See MedPAC’s letter to CMS here.…

Low-Income Patients More Likely to End Up in Low-Quality SNFs

Dually eligible individuals are more likely than others to find themselves in low-rated skilled nursing facilities, recent research has found.

According to a study published in the Journal of Applied Gerontology, more than 50 percent of dually eligible individuals – those covered by both Medicare and Medicaid – who are admitted to skilled nursing facilities are served by facilities that have low (one or two stars) ratings under Medicare’s five-star quality rating system for nursing homes.  Overall, the dually eligible are 9.7 percentage points more likely than patients not on Medicaid to be served by lower-rated facilities.

The education of those individuals and their distance from higher-quality facilities are the two leading reasons.  According to the study, lower-quality skilled nursing facilities are more likely to be located in or near low-income communities.  Health status and race also are contributing factors.

Learn more in the Journal of Applied Gerontology article “Medicaid and Nursing Home Choice:  Why Do Duals End Up in Low-Quality Facilities?” and from the McKnight’s Long-Term Care News report “More than 50% of dual-eligibles end up in low-rated SNFs, study finds.”

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Feds Looking to Bundle Medicare Post-Acute Payments?

Bring us your ideas for bundling Medicare post-acute-care payments, the head of the Center for Medicare and Medicaid Innovation recently told a gathering of hospital officials in Washington, D.C.

As reported by Fierce Healthcare, CMMI director Adam Boehler told hospital officials that

Now is the time to bring us ideas.  We’re really in listening mode…I think there’s been a lot of intrigue and interest we’ve heard from people.  So we’re gathering stakeholder input there on that and it’s a great time to give us thoughts on where we can lower costs.

Learn more from the Fierce Healthcare article “CMMI’s Adam Boehler: ‘Now is the time’ to bring post-acute care bundle ideas.”