MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s December agenda were:

  • Medicare payments for physician and other health professionals services
  • payments for ambulatory surgical centers
  • payments for hospital inpatient and outpatient care
  • Medicare’s hospital quality incentive program
  • payments for skilled nursing facilities
  • payments for long-term care hospitals
  • payments for inpatient rehabilitation facilities
  • the Medicare Advantage program

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.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.

MedPAC Talks Payments

At public meetings in Washington, D.C. last week, members of the Medicare Payment Advisory Commission discussed the adequacy of current Medicare payments and whether they need updating in the next fiscal year.

Among the payment areas MedPAC reviewed were inpatient services, outpatient services, physician and health professional services, ambulatory surgical center services, skilled nursing facilities, home health services, inpatient rehabilitation hospitals, long-term-care facilitiies, outpatient dialysis services, and hospices.

Find the issue briefs and presentations used to guide these discussions here, on MedPAC’s web site.

MedPAC Meets, Talks Alternative Payment Models, Medicare Advantage Star Ratings, More

The agency that advises Congress on Medicare payment issues met last week in Washington, D.C.

new medpacDuring two days of public meetings the Medicare Payment Advisory Commission (MedPAC) heard presentations about and discussed a number of issues of interest to private safety-net hospitals, including alternative payment models and merit-based incentive payment systems and factors affecting variation in Medicare Advantage plan star ratings.

For links to policy briefs and presentations on these and other subjects, go here.

To see a transcript of the two days of meetings, go here.

Members of Congress Seek Increased Medicare Rates

US Capitol DomeMembers of Congress have written to Centers for Medicare & Medicaid Services (CMS) acting administrator Andrew Slavitt asking him to reconsider his agency’s proposal to reduce the rates Medicare will pay providers for outpatient services.

In July, CMS proposed reducing those outpatient rates 0.2 percent in calendar year 2016.

The letter notes that

According to MedPAC, Medicare already pays hospitals less than 88 cents on the dollar for outpatient services and this rule will make that situation worse for our constituents – both hospitals and patients alike.

The letter also states that

Medicare already pays providers less than the cost of care. Prescribing a negative update to OPPS [note: outpatient prospective payment system] payment rates will only make it more difficult for hospitals to serve their patients and their communities, particularly as they move to adopt delivery system reforms.

To see the letter, including the names of the 95 Democrats and Republicans who signed it, go here.

CMS Proposes FY 2014 Medicare Payments

Medicare inpatient payments would rise 0.8 percent in FY 2014 under a new proposed regulation published last week by the Centers for Medicare & Medicaid Services (CMS).

The proposed inpatient prospective payment system regulation – all 1424 pages of it ­– also outlines a new approach to the calculation of Medicare disproportionate share hospital payments (Medicare DSH), introduces changes in Medicare’s value-based purchasing program and hospital readmissions reduction program, and unveils a new patients safety program to be launched in FY 2015.

Learn more about Medicare’s proposed approach to paying hospitals and find a link to the full regulation itself herecms, on the Healthcare Finance News web site.

Fiscal Cliff Poses Threat to Urban Safety-Net Hospitals

Congress and the Obama administration are now negotiating possible solutions to the fiscal cliff crisis.

A number of the solutions that have been discussed in the recent past would pose especially major problems for urban safety-net hospitals.  Those “solutions” include:

  • further reductions in annual Medicare updates
  • reductions in hospitals’ Medicare outpatient evaluation and management (E&M) fees
  • further reductions in Medicare bad debt reimbursement
  • new limits on the provider taxes states can levy to finance their Medicaid program
  • further reductions in Medicaid disproportionate share (Medicaid DSH) payments
  • a reduction in the rate at which the federal government matches states’ share of Medicaid spending (the federal medical assistance percentage, or FMAP)
  • delayed implementation of the Affordable Care Act’s Medicaid expansion

As these negotiations continue, members of the National Association of Urban Hospitals (NAUH) will remind their congressional delegations that such cuts could have disastrous implications for the nation’s private, non-profit urban safety-net hospitals.


NAUH Comments on Proposed Medicare Payment Regulation

The National Association of Urban Hospitals (NAUH) has expressed reservations about eight aspects of the proposed Medicare inpatient prospective payment regulation governing Medicare payments for FY 2013.

In a formal comment letter to the Centers for Medicare & Medicaid Services (CMS),  NAUH addressed the proposed Medicare inpatient payment update, the new outlier threshold, Medicare disproportionate share (Medicare DSH) payments, medical education payments, the hospital readmissions reduction program, the value-based purchasing program, the Hospital Consumer Assessment of Health Providers and Systems (HCAHPS), and sole-community hospitals.

The proposed regulation was published in May and will take effect, as amended, in October.  NAUH comments annually on CMS’s Medicare payment proposal and has seen many of the concerns it has raised over the years reflected in the final, revised regulation.

Read NAUH’s comment letter hereNAUH Logo.

NAUH’s June 2012 Newsletter

Read about Medicare’s plans for paying hospitals for inpatient care in FY 2013 – both what its proposed inpatient prospective payment system regulation says and what it does not say – in the June 2012 edition of NAUH Update, the National Association of Urban Hospital’s newsletter.

Among the provisions in that proposed regulation is a new hospital readmissions reduction program.  While this new program would judge all hospitals according to a single set of criteria, the American Heart Association recently shared research that found that hospital readmission rates are more closely tied to socioeconomic factors and access-to-care issues than they are to hospitals’ performance – something NAUH has long maintained.  Read about these new findings in the June NAUH Update as well.

Download the June 2012 edition of NAUH Update hereNAUH Logo.