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MedPAC: Overhaul Medicare Quality Programs

Medicare would implement major changes in its hospital quality programs under a proposal approved by the Medicare Payment Advisory Commission.

Fierce Healthcare reports that the proposal adopted by MedPAC for recommendation to Congress and the Centers for Medicare & Medicaid Services

…would essentially lump together several existing programs that measure quality—the Hospital Readmissions Reduction Program, the Hospital Value-Based Purchasing Program and the Hospital-Acquired Condition Reduction Program—into the Hospital Value Incentive Program (HVIP). 

It would also eliminate the existing Inpatient Quality Reporting Program.

Under the MedPAC proposal,

Performance across five domains—readmissions, mortality, spending, patient experience and hospital-acquired conditions—would be converted to HVIP “points.” Those points would be used to distribute the pool of funds instead of penalizing hospitals as the current system does. 

MedPAC estimates that hospitals might experience a 3.3 percent net increase in Medicare payments under its proposal; the current, multi-program approach would yield as much as a 2.8 percent increase.

MedPAC will encourage Congress and CMS to act quickly and implement its proposal in 2020.

Private safety-net hospitals have not always felt fairly treated by some of these quality programs, maintaining that their patients face socio-economic obstacles that make them more challenging to serve than the patients most community hospitals serve and that comparisons with most community hospitals – often the basis for quality ratings and either financial penalties or rewards – are inappropriate.

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Learn more about the MedPAC hospital quality proposal and other recent MedPAC proposals in the Fierce Healthcare article “MedPAC recommends overhaul to Medicare’s hospital quality programs.”