Medicare reform proposal needs fixes for long-term care physicians, AMDA says

Share this article:

Prospective Medicare changes regarding physician payments might unfairly penalize doctors working in long-term care settings, according to a prominent medical directors association.

AMDA-Dedicated to Long-Term Care (formerly the American Medical Directors Association) registered its concerns in a Nov. 12 letter to leaders of the Senate Finance Committee and House Ways and Means Committee. AMDA was responding to a discussion draft of legislation to repeal Medicare's physician payment formula and enact other Medicare payment reforms.

A repeal of the Sustainable Growth Rate — the formula for determining Medicare payment rates for physicians — would mean that a new system would have to be implemented. This system likely would tie payment rates to quality measures, and AMDA is concerned that current and proposed measures are not a good fit for long-term care physicians.

For example, the government has set incentives for physicians to meet “meaningful use” thresholds for electronic health records. However, LTC physicians are practicing in settings that have not adopted EHR technology on a broad scale, in large part because they have been excluded from government programs making adoption more affordable. Tying physician payments to meaningful use requirements would therefore harm LTC doctors, AMDA argued in its letter.

The letter also raised concerns regarding a potential value based purchasing model. Here, incentive payments would be made to physicians who meet performance standards. These standards might not apply in LTC settings, where “patient improvement is minimal or not expected,” AMDA noted.

Click here to access the full letter.

Share this article:

More in News

Congressman requests briefing on nursing home five-star rating system

Congressman requests briefing on nursing home five-star rating ...

A leader in Congress has called for an evaluation of the nursing home five-star rating system in light of a recent New York Times article. Rep. Elijah Cummings (D-MD) requested ...

CMS: Discharge assessments must be completed when residents transfer to a non-certified ...

Skilled nursing facilities must complete a discharge assessment when a resident is transferred from a certified to a non-certified bed, even if both beds are in the same building, the Centers for Medicare & Medicaid Services emphasizes in a recent memorandum.

Focusing on a single word might improve nursing home residents' quality of ...

An affordable, easily implemented relaxation technique could improve nursing home residents' psychological well-being. It also could potentially boost their immune systems, according to recently published findings.