Medicare should pay for certain medical services on a site-neutral basis and not pay different rates for the same services to inpatient rehabilitation hospitals and skilled nursing facilities.

Or so says MedPAC, the independent federal agency charged with advising Congress on Medicare payment policy.

MedPAC has offered this recommendation in the past and presents it again in its June 2014 report to Congress.

In researching this recommendation, MedPAC looked at three medical conditions in which patients recover at either rehab hospitals or skilled nursing facilities:  major joint replacement, selected hip and femur procedures, and strokes.  It found that for the two forms of orthopedic care, there were few if any differences in patient recovery between the two types of facilities.  As a result, MedPAC recommends that both facilities should be paid at the (lesser) skilled nursing facility rates for such care – that is, on a site-neutral basis.

MedPAC found that stroke recovery care is more complex and requires further research.

The National Association of Urban Hospitals (NAUH) opposes site-neutral payments.

Learn more about MedPAC’s June 2014 recommendations, including this one involving Medicare site-neutral payments, in this MedPAC fact sheet.  Find the entire MedPAC June 2014 report to Congress here.