Readmissions Program Working; Expansion in Order?

The Medicare hospital readmissions reduction program is working, according to the Medicare Payment Advisory Commission.

And it may even be worth expanding to additional medical conditions, MedPAC members believe.

According to MedPAC, hospital readmissions among patients with medical conditions covered by the readmissions reduction program have declined faster than readmissions among patients with medical conditions not covered by the program, suggesting that expanding the program to additional medical conditions could lead to an even greater reduction in the number of avoidable Medicare-covered readmissions.

Learn more about changes in the readmission rate since the readmissions reduction program was introduced and whether those reductions can accurately be attributed to the program this MedPage Today article.

MedPAC Meets

The Medicare Payment Advisory Commission, which advises Congress on Medicare payment issues, met last week in Washington, D.C.

Among the issues on MedPAC’s agenda were:

  • paying for sequential stays in a unified Medicare payment system for post-acute care
  • encouraging Medicare beneficiaries to use higher-quality post-acute care providers
  • using payment policy to ensure appropriate access to and use of hospital emergency department services
  • the Centers for Medicare & Medicaid Services’ financial alignment demonstration for dual-eligible beneficiaries
  • the effectiveness of the Medicare hospital readmissions reduction program
  • population-based quality measures such as preventable admissions and home and community days

Go here, to MedPAC’s web site, to see the issue briefs and presentations that supported the discussion of these issues.

Docs Not Scoring Performance Bonuses

Relatively few physicians will receive Medicare pay-for-performance bonuses under Medicare’s value-based modifier program in 2018.

The question now is whether this is because of uninspiring performance or indifference to the program.

Of the approximately 1.1 million clinicians who participate in Medicare, only two percent – 22,000 – will receive pay increases in 2018 based on their 2016 performance.  Those raises will range from 6.6 percent to 19.9 percent.

Most doctors will receive neither bonuses nor penalties.

And roughly 300,000 failed to submit the data required by the program.  In the past they would have been penalized for this failure but that penalty was eliminated for what is now the final year of the program.

Medicare now moves to a new merit-based incentive payment system – and this program, even though it is just beginning, has already been targeted for elimination by the Medicare Payment Advisory Commission.  MedPAC recommended eliminating the new program, known as MIPS, at its meeting earlier this month.

Learn more about physician performance under the value-based modifier program from this CMS fact sheet.

MedPAC Meets

Last week the Medicare Payment Advisory Commission held two days of public meetings in Washington, D.C.

During the sessions MedPAC, a non-partisan legislative branch agency that advises Congress on Medicare payment issues, addressed the following subjects:

  • a Medicare Advantage status report
  • a Medicare prescription drug program (Part D) status report
  • hospital inpatient and outpatient payments
  • physician payments
  • ambulatory surgical center, dialysis center, and hospice payments
  • post-acute care facility payments
  • the hospital readmissions reduction program
  • telehealth
  • accountable care organizations

Go here to see the issue briefs and presentations used during the meetings.

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week.

Among the issues on the agenda of the independent agency that advises Congress on Medicare payment issues were:

  • payment adequacy for physicians and other health professional services
  • An alternative to the merit-based incentive payment system (MIPS)
  • payment adequacy for hospital inpatient and outpatient services
  • payment adequacy for ambulatory surgical center services
  • the status of the Medicare Advantage program

Find links to issue briefs on these subjects and the presentations offered at the meeting by going here, to the MedPAC web site.

MedPAC Meets

The independent agency that advises Congress and the administration on Medicare payment policies met last week in Washington, D.C.

Among the issues discussed at the meeting of the Medicare Payment Advisory Commission were:

  • the merit-based incentive payment system
  • telehealth
  • a redesign of Medicare’s hospital value incentive program

Many of the issues MedPAC addresses – including those noted above – are very important to private safety-net hospitals.

Find the presentations and issue briefs for these subjects and others discussed at the MedPAC meeting here, on MedPAC’s web site.

MedPAC Comments on Proposed Physician Fee Schedule

The Medicare Payment Advisory Commission has written to the Centers for Medicare & Medicaid Services to convey its views on CMS’s proposed revisions to Medicare physician payment policies for 2018.

Among the issues MedPAC addresses in its comment letter are proposed payments to physicians for nonexcepted items and services provided in nonexcepted off-campus provider-based hospital departments, the Medicare shared savings program, and the Medicare diabetes prevention program.

Return here later this week to learn about NAUH’s comment letter about the same proposed regulation.

See MedPAC’s comment letter here.

MedPAC Comments on Proposed Medicare Outpatient Payment Rule

The Medicare Payment Advisory Commission has weighed in with the Centers for Medicare & Medicaid Services on its proposed regulation governing the 2018 hospital outpatient prospective payment system and ambulatory surgical center payment systems and quality reporting programs.

Among the issues MedPAC addresses in its comment letter to CMS are the proposal to reduce Medicare reimbursement for 340B-covered prescription drugs; how to reinvest the savings such a payment cut would produce; the ability of hospitals to expand the services they offer at hospital-based outpatient departments; proposed changes in the Medicare hospital outpatient quality reporting program and ambulatory surgery center quality reporting program; and more.

Visit this space later this week to see NAUH’s comment letter on the same subject.

 See MedPAC’s formal comment letter here.

MedPAC Delivers Annual Report to Congress

The Medicare Payment Advisory Commission has issued its annual report and recommendations to Congress.

The major issues addressed in the report include:

  • implementing a unified payment system for post-acute care
  • reforming Medicare payment for drugs under Part B
  • redesigning the merit-based incentive payment system (MIPS) and strengthening advanced alternative payment models
  • using premium support for Medicare
  • the relationship between clinician services and other Medicare services
  • payments from drug and device manufacturers to physicians and teaching hospitals in 2015
  • the medical device industry
  • stand-alone emergency departments
  • hospital and skilled nursing facility use by Medicare beneficiaries who reside in nursing facilities
  • the role of Medicare policy in provider consolidation

To learn more about MedPAC’s annual report to Congress, see this MedPAC news release, this fact sheet, and the report itself.

MedPAC Meets

The Medicare Payment Advisory Committee met last week in Washington, D.C.

Among the issues on MedPAC’s agenda were:

  • using premium support in Medicare
  • regional variation in Medicare Part A, Part B, and Part D spending and service use
  • measuring low-value care in Medicare
  • the role of Medicare policy in provider consolidation

Find the issue briefs and presentations that supported MedPAC commissioners’ discussion of these issues here and find a transcript of the two days of meetings here.