MedPAC Archives - Safety-Net Association of Pennsylvania

MedPAC: Small Pay Raise for Hospital Inpatient, Outpatient Services

The independent agency that advises Congress on Medicare payment matters has recommended modest increases in Medicare payments for hospital inpatient and outpatient services in FY 2018.
The Medicare Payment Advisory Commission voted in support of a market basket increase of approximately 1.85 percent for Medicare outpatient and inpatient services in FY 2018.
MedPAC also voted to recommend a 0.5 percent increase in payments to physicians but no increase for ambulatory surgery centers.
MedPAC will formally submit its recommendations to Congress in March.
Learn more about these and other MedPAC recommendations for changes in Medicare provider reimbursement in this article on the Provider web site.

PA Safety Net Admin2017-01-20T06:00:54+00:00January 20th, 2017|Medicare|Comments Off

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.

PA Safety Net Admin2016-12-13T06:00:37+00:00December 13th, 2016|Medicare|Comments Off

MedPAC Offers DSH, 340B Recommendations

The Medicare Payment Advisory Commission has recommended that Congress direct changes in the 340B prescription drug discount program and in the manner in which Medicare makes disproportionate share hospital payments (Medicare DSH).
In its annual report to Congress, MedPAC recommended a reduction in 340B prescription drug payments to hospitals. The proposed reduction would cut 340B program spending approximately $300 million.
MedPAC then recommended that those 340B savings be redirected to the Medicare DSH uncompensated care pool.
And it also called for distributing the money in that pool based on better data on the uncompensated care hospitals provide, as reported on hospitals’ Medicare cost report S-10 worksheets, so that the Medicare DSH uncompensated care program would “…better target additional payments to hospitals that provide above average shares of uncompensated care.”
Most Pennsylvania safety-net hospitals participate in both the 340B and Medicaid DSH programs.
To learn more about these and other MedPAC recommendations, see the news release that accompanied the MedPAC report to Congress; a fact sheet on that report; and the report itself.

PA Safety Net Admin2016-03-23T06:00:39+00:00March 23rd, 2016|Medicare|Comments Off

MedPAC Meets, Discusses Payment Issues

Last week the commissioners serving on the Medicare Payment Advisory Commission (MedPAC) met in Washington, D.C. to discuss the group’s future recommendations to Congress.

While MedPAC’s recommendations are not binding on Congress or the administration, they are highly respected and often find themselves worked into new law or regulations.
Among the issues MedPAC addressed during two days of public meetings were:

Medicare inpatient and outpatient payments
the Medicare Advantage program star rating system
payments to ambulatory surgery centers, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals
payments for physician services, home health services, hospice care, and outpatient dialysis

Find issue briefs on each subject, and copies of the presentations MedPAC staff made to commissioners, here on MedPAC’s web site.

PA Safety Net Admin2015-12-14T15:53:19+00:00December 14th, 2015|Medicare|Comments Off

MedPAC Looks at Various Issues at September Public Meeting

The independent federal agency that advises Congress on Medicare payment issues held its monthly public meeting in Washington, D.C.
During the two days of meetings, the Medicare Payment Advisory Commission (MedPAC) discussed its work on six specific issues:

developing a unified payment system for post-acute care
a preliminary analysis of Medicare Advantage encounter data for Part B services
factors affecting variation in Medicare Advantage plan star ratings
Medicare drug spending
emergency department services provided at stand-alone facilities
payments from drug and device manufacturers to physicians and teaching hospitals

Each discussion was accompanied by an issue brief and a presentation; find those documents here.

PA Safety Net Admin2015-09-16T06:00:54+00:00September 16th, 2015|Medicare|Comments Off

MedPAC Calls for End of “Two-Midnight Rule”

The independent agency that advises Congress on Medicare payment issues has recommended that Medicare eliminate its controversial two-midnight rule.
At its recent meeting in Washington, D.C., the Medicare Payment Advisory Commission (MedPAC) also recommended that Medicare focus RAC (Recovery Audit Contractor) audits on hospitals with the highest numbers of short inpatient stays, shorten the look-back period for audits, modify the three-day rule for skilled nursing facility coverage, and require hospitals to inform patients when their stay has been classified as observation status rather than inpatient status.
Learn more about MedPAC’s recommendation in this Fierce Healthcare news report and go here to see the MedPAC presentation of the recommendations the agency’s board approved.

PA Safety Net Admin2015-04-16T06:00:40+00:00April 16th, 2015|Medicare|Comments Off

MedPAC Looks at Short-Stay Issues

The agency that advises Congress on Medicare payment issues is preparing to suggest changes in how Medicare approaches paying for short hospital stays.
At last week’s meeting of the Medicare Payment Advisory Commission (MedPAC), commissioners received a staff presentation on issues surrounding Medicare payments for short hospital stays and discussed possible recommendations for changes in how Medicare pays for those short hospital stays.
Among the possibilities discussed at the recent MedPAC meeting are revising how Medicare’s recovery audit contractors program (RAC audits) looks at short hospital stays; revising the three-day-stay requirement for Medicare to cover post-discharge skilled nursing care; penalizing hospitals found to have unusually large numbers of short stays; and shortening the time-frame during which individual cases are subject to RAC audits.
See the presentation made to MedPAC members here. Also, see this CQ HealthBeat report presented by the Commonwealth Fund on the MedPAC meeting at which this issue was discussed.

PA Safety Net Admin2015-03-11T06:00:18+00:00March 11th, 2015|Uncategorized|Comments Off

MedPAC Considers FY 2016 Pay Boost for Inpatient, Outpatient Payments

Medicare payments to hospitals for inpatient and outpatient care could rise 3.25 percent in the coming fiscal year.
At least that is what members of the Medicare Payment Advisory Commission (MedPAC) discussed recommending to Congress when they met last week in Washington.
During MedPAC’s two-day public meeting, members discussed recommending to Congress a 3.25 percent increase in Medicare inpatient and outpatient payments in FY 2016. They will vote on their recommendation at their next meeting.
A presentation to MedPAC members by their staff also offered a number of observations about Medicare services:

Demand for hospital services is stable.
With hospital occupancy down to 60 percent, it appears hospitals have excess capacity.
The quality of care hospitals provide is improving according to several metrics.
Hospital cost growth is down.
Hospitals’ Medicare margins are steady, although they remain negative, especially for outpatient services.
MedPAC should consider recommending policies to reduce or eliminate differences between payments to hospitals and doctors’ offices for selected outpatient services.

For a closer look at the Medicare inpatient and outpatient issues MedPAC examined at its December meeting, see the presentation on this subject here, on MedPAC’s web site.

PA Safety Net Admin2014-12-23T06:00:27+00:00December 23rd, 2014|Uncategorized|Comments Off

MedPAC Meets, Addresses Hospital Issues

The independent federal agency that advises Congress on Medicare payment issues met last week in Washington and addressed a number of issues of importance to hospitals.
Among the issues discussed by the Medicare Payment Advisory Commission (MedPAC) were:

beneficiary access to hospital care and how service volume affects hospital costs
hospital short stay policy issues
per beneficiary payment for primary care
the 340B drug pricing program
site-neutral payments for selected conditions treated in inpatient rehabilitation facilities and skilled nursing homes
payment policies to promote the use of services based on clinical evidence

Find links to the presentations offered by MedPAC staff on these issues here, on MedPAC’s web site.

PA Safety Net Admin2014-11-17T06:00:53+00:00November 17th, 2014|Uncategorized|Comments Off

MedPAC: Keep Paying More For Medicare Primary Care Services

The federal government should continue paying extra for primary care services provided to Medicare patients, Congress has been told by its chief advisor on Medicare payment policy.
According to the Medicare Payment Advisory Commission (MedPAC), the independent federal agency that advises Congress on Medicare payment matters, Medicare has long undervalued primary care services in comparison to specialty medical care, and in 2010 the Affordable Care Act introduced a ten percent bonus for primary care services provided to seniors through 2015.
With the expiration of that bonus coming in a little more than a year, MedPAC has told Congress it should seek to continue the practice but perhaps by making the additional payment on a per beneficiary basis rather than a per visit basis, to make such an approach part of the broader effort to discourage the volume provision of services and to encourage outcomes-oriented care.
In its June 2014 report to Congress, MedPAC also outlines how such a payment might work.
Pennsylvania’s safety-net hospitals all care for significant numbers of Medicare patients, including many low-income seniors.
Learn more about MedPAC’s overall recommendations, including this one involving Medicare primary care payments, in this MedPAC fact sheet. Find the entire MedPAC June 2014 report to Congress here.

PA Safety Net Admin2014-06-17T06:00:28+00:00June 17th, 2014|Affordable Care Act|Comments Off

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