Though it contains no formal recommendations, the Medicare Payment Advisory Commission's (MedPAC) June report describes the commission's exploration into the possibility of future changes in several areas, including the idea of paying the same rates to inpatient rehabilitation facilities (IRFs) as are paid to skilled nursing facilities (SNFs) for some types of postacute care. The report was the subject of a June 18 hearing of the House Ways and Means Committee's Health Subcommittee.
The MedPAC report (.pdf), released June 13, is focused on 7 areas: bringing payments in line across fee-for-service, Medicare Advantage, and accountable care organizations (ACOs); measuring quality of care in Medicare; improving risk adjustments; financial assistance for low-income beneficiaries; per-beneficiary payment for primary care; measuring the effects of medication adherence for the Medicare population; and payment differences across postacute settings.
In the postacute settings portion of the report, MedPAC looks specifically at outcomes for major joint replacement, other hip and knee procedures, and stroke, assessing differences between IRFs and SNFs. Although the report notes more analysis must be done to account for variability in stroke treatment, MedPAC's initial findings are that joint replacement and other hip and knee procedures may have similar outcomes, and are "a good starting point for a site-neutral policy," which would aim to bring payments to IRFs more in line with SNF payments.
APTA staff attended the subcommittee hearing, in which Chairman Kevin Brady (R-TX), described MedPAC as a "key nonpartisan advisor with a lot of analytical firepower." MedPAC Executive Director Mark Miller was on hand to testify, and his testimony was posted (.pdf) on the Ways and Means Committee's website.
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