MedPAC Recommends Update Reductions for Some, Increases for Others

MedPAC last week proposed to reduce hospital inpatient and outpatient  rates from 2.9 percent in 2012 to 1 percent in 2013 and freeze them at  that level for five years in order to recover an estimated $11 billion  in 2010-2012 over payments due to documentation and coding methods.  A  very good MedPAC powerpoint summary of several key issues can be seen by  clicking here  Issues  include payment updates, rural vs. urban payments and E&M payments.  MedPAC recommended a zero percent update for 2013 on skilled nursing  facilities (SNFs), as well as rebasing payment rates in 2014 with an  initial reduction of 4 percent and further cuts over a period of time in  an effort to better align Medicare payments with provider costs.  MedPAC  said Congress should direct the HHS secretary to cut pay to SNFs with  higher rates of risk-adjusted rehospitalization rates for their stays.   MedPAC said SNF Medicare margins in 2010 were 18.5 percent.  Click here for MedPAC’s powerpoint on  SNFs.  MedPAC proposed a 1 percent increase for dialysis, a 0.5 percent  increase for ASCs, a 0.5 percent increase for Hospice, and eliminating  the update for inpatient rehab and long term care hospitals. Click here for MedPAC’s powerpoint on  LTCHs.  For home health, commissioners discussed rebasing their payments in  2013, which would lower payments overall and recommended changing the  home health payment system to take away incentives to provide  unnecessary services to patients.  Rebasing would include an initial  reduction of 4 percent and subsequent reductions over an appropriate  transition until Medicare’s payments are better aligned with providers’  costs, according to MedPAC.  Click here  for MedPAC’s home health very informative presentation.  MedPAC will vote on its current recommendations to Congress in January.


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