During an earlier announcement, we shared the summary about the MedPAC 2016 payment rate and programmatic recommendations for inpatient and outpatient hospitals as well as for ambulatory surgical centers. This summary discusses skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals.
MedPAC uses the following indicators to determine whether the Medicare payment rates for skilled nursing facilities (SNFs) are at appropriate levels: capacity and supply of providers, volume of services, quality of care, providers’ access to capital, and provider costs. Using these, MedPAC made the same recommendations for this March 2015 report as they have in previous reports to Congress. The recommendations include:
MedPAC uses the same indicators that they use for SNFs to determine whether Medicare payment rates for inpatient rehabilitation facilities (IRFs) are adequate. The March 2015 MedPAC recommendations for IRFs include:
MedPAC uses the same indicators that they use for SNFs and IRFs to determine whether Medicare payment rates for long-term care hospitals (LTCHs) are adequate. Although the first part of this three-part series already outlined some of the MedPAC March 2015 report recommendations for LTCHs, the following includes those and additional recommendations from the report:
It is unclear if Congress or CMS will act on these recommendations with either legislative or regulatory action. However, if the current sustainable growth rate (SGR) repeal bill is signed into law, there will be changes made to payment rates for some of these facilities. We will continue to monitor the SGR bill and any other policy or regulatory initiatives regarding payments to these types of facilities. The third part of this series will outline the MedPAC recommended 2016 payment rates and program updates to home health and hospice services.
On March 13, the Medicare Care Payment Advisory Commission (MedPAC) released the first of its two 2015 reports to Congress. MedPAC is comprised of seventeen commissioners that meet throughout the year and then release a report to Congress in March and June of each year summarizing their conclusions and providing recommendations on various aspects of Medicare policy. The March 2015 report provides, among others, recommendations regarding Medicare payment rates and programs to different types of providers, a summary of the Medicare Advantage and Part D programs, and other major policy reform recommendations such as a permanent repeal of the sustainable growth rate (SGR) formula.
For more information on this topic, or to learn how Baker Tilly healthcare specialists can help, contact our team.