MedPAC Mulls Unified Post-Acute Care Payment System
The Medicare Payment Advisory Commission (MedPAC) addressed plans to develop a unified prospective payment system for post-acute care when it met on September 10 in Washington, DC.
The plan, mandated by Congress under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, would reimburse skilled nursing facilities, long-term care hospitals, inpatient rehabilitation facilities, and home health agencies under one payment system.
Post-acute care providers will likely see changes in how much they are reimbursed, which, according to Modern Healthcare, prompted attendees at September’s meeting to question the potential impact to patients. Some requested a mandate that the prospective payment system model be evaluated to weigh the effect it would have on patients.
“How will we know if we’re doing more harm than good if we recommend a change but don’t know how it turns out?” said Kathy Buto, MedPAC member and independent health policy consultant in Arlington, VA, according to the Modern Healthcare report (bit.ly/1OJjQdL).
Whether the unified payment system will base reimbursement rates on the patient’s medical condition or on the type of post-acute care setting where the care is provided is still being decided. One potential strategy would put skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals under one model and home health agencies under another. The former would receive payment for non-therapy ancillary services such as medications and ventilator care, whereas the latter would not.
Non-therapy ancillary services make up 44% of long-term care hospital costs, 17% of inpatient rehabilitation facility costs, and 13% of skilled nursing facility costs, according to a MedPAC presentation made at the meeting.
The IMPACT Act requires MedPAC to submit a report to Congress presenting an approach for a unified payment system for post-acute care, as well as the potential impacts such a system could have, by June 30, 2016.
In their presentation to the Medicare Payment Advisory Commission on September 10, 2015, MedPAC analysts Carol Carter and Dana Kelley noted that the “complex undertaking will require multiple presentations over the coming month.”—Jolynn Tumolo
