News: Value-based payments coming to post-acute care

During last week’s Medicare Payment Advisory Commission (MedPAC) meeting, MedPAC proposed a program that would tie quality to payments for skill nursing facilities, home health service, inpatient rehabilitation facilities, and long-term care hospitals.

The program builds on MedPAC’s previous work to develop a standard set of measures for post-acute care settings, and define and apply a set of principles that use Medicare payments to improve the quality of care, according to Modern Healthcare.

MedPAC said that a unified prospective payment system across the four post-acute settings requires a uniform value incentive program, emphasizing that beneficiaries with similar health statuses are often treated in different settings so the program should evaluate providers with a common set of measures.

The proposed program includes a few risk-adjusted claims-based measures, according to Modern Healthcare, including all-condition hospitalization within the post-acute care stay, successful discharge to the community, and Medicare spending per beneficiary.

The program would score performance using prospectively set targets and would also account for social risk factors by comparing providers with similar shares of dual-eligible beneficiaries. MedPAC proposed that there would be a 5% reimbursement withholding that would fund the incentive payments, though that number could change based on member feedback.

Over the next year, MedPAC said that they would review the program, model it based on the commission’s feedback, and present the results in 2020.

Editor’s note: To read all the materials presented during the MedPAC meeting last week, click here. To read Modern Healthcare’s coverage of this story, click here.