Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.
Post acute-care, such as in nursing homes, could see a three-year transition to a new pay system starting in 2021, under an approach apparently favored by a Medicare payment advisory body.
The Medicare Payment Advisory Commission, which is set to vote in April on its recommendations to Congress, discussed March 2 the impact of a move to a unified prospective payment system across different settings for post-acute care. Currently, providers are reimbursed based on a fixed single amount that may benefit some treatment settings over others.
MedPAC has recommended moving post-acute care settings to a new system over several years. The commission says such a system would create a uniform payment system across all post-acute settings (including long-term care hospitals, home health-care providers and nursing homes), base payments on patient characteristics instead of where patients are treated and eliminate biases that favor treating some conditions over others.
Most commission members seemed to support a three-year transition, with two years of blended rates between the current and proposed systems and the third year being the new rate.
One commissioner said this would allow a smoother transition of rates for providers.
Another commissioner, Bruce Pyenson, said a three-year transition meant the industry was being given seven years from legislation to final implementation, which he suggested is quite generous. Pyenson is principal and consulting actuary at Milliman, Inc., an independent actuarial and consulting firm.
At their meeting, commissioners also considered a slate of other draft proposals, which most commissioners appeared to support:
In a June 2016 report, MedPAC said a unified payment system could be implemented sooner than the current timetable of 2024 and later.
The chairman of the commission, Francis J. Crosson, recommended March 2 starting the transition in 2021. However, MedPAC principal policy analyst Carol Carter said the implementation’s start date would depend on when Congress decides to act on MedPAC’s proposal.
The commission also discussed what kind of timetable for legislation the Medicare agency would need to implement the system.
MedPAC will continue its meeting March 3. The next report from the commission to Congress is scheduled for June.
To contact the reporter on this story: Mike Stankiewicz in Washington at firstname.lastname@example.org
To contact the editor responsible for this story: Brian Broderick at email@example.com
Copyright © 2017 The Bureau of National Affairs, Inc. All Rights Reserved.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to firstname.lastname@example.org.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to email@example.com.
Put me on standing order
Notify me when new releases are available (no standing order will be created)