MedPAC looks at post-acute care unified payment system

The Medicare Payment Advisory Commission (MedPAC) continues to explore what a unified payment system for post-acute care (PAC) in the Medicare program would look like despite what an industry analyst says is no apparent movement to do so in Congress, according to Provider.

At its most recent public meeting, the commission heard a staff report on the basis for uniform outcome measures as part of such a unified payment model for skilled nursing facilities (SNFs), home health agencies (HHAs), long term care hospitals (LTCHs), and inpatient rehabilitation facilities (IRFs).

Just last month, MedPAC released its March Report to Congress that recommends for fiscal year 2019 Congress “eliminate the market basket update for SNFs for fiscal years 2019 and 2020 and direct the secretary [of Health and Human Services] to implement a redesigned prospective payment system [PPS] in fiscal year 2019 for SNFs.”

For this latest review, the commission heard from staff member Carol Carter on unified outcome measures, which the staff report said are needed to compare provider performance across PAC settings. “The program will be able to evaluate the quality and the value of its purchases while providers and beneficiaries will be able to directly compare outcomes for different types of PAC providers,” she said.

A second basis for uniform outcome measures is when the Centers for Medicare & Medicaid Services (CMS) implements a unified PAC payment system, it will be critical to monitor provider performance, including whether providers maintain quality of care and furnish appropriate use of PAC and other services.

Carter said the last reason for the measures is for their possible use in a value-based purchasing policy for all PAC providers. “By tying a portion of a provider's payments to its performance on quality and resource use, providers would have an incentive to achieve good outcomes while using resources efficiently,” she said.

Read the full story at Provider.

Topics: Executive Leadership , Leadership , Medicare/Medicaid , Regulatory Compliance , Uncategorized