MedPAC calls for permanent reauthorization of Medicare Advantage plan covering nursing home residents

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Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments
Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments

The Medicare Advantage special needs plan that enrolls nursing home residents, set to expire at the end of 2014, will be permanently reauthorized if Congress acts on recommendations proposed by the Medicare Payment Advisory Commission (MedPAC).

Institutional special needs plans (I-SNPs), which cover about 50,000 beneficiaries in long-term care facilities, outperform other SNPs and Medicare Advantage plans on quality measures such as hospital readmission rates, according to MedPAC figures presented at a public meeting Thursday in Washington, D.C.

The low readmission rates indicate I-SNPs provide more integrated, coordinated care to enrolled beneficiaries than fee-for-service plans. Based in part on I-SNPs' high marks for improving integrated care, MedPAC commissioners unanimously recommended that Congress permanently reauthorize them, according to the Bureau of National Affairs (BNA).

MedPAC also outlined steps to improve D-SNPs, which enroll beneficiaries eligible for both Medicare and Medicaid. D-SNPs will be able to better integrate with Medicaid if Congress addresses Medicare/Medicaid misalignments such as separate appeals and grievance processes, MedPAC commissioners said, according to BNA.

Dual-eligible issues are of interest to long-term care operators, as LTC services account for a majority of the $150 billion in Medicaid spent on duals, a recent report showed.

A full transcript of the MedPAC meeting will be posted here.

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