MedPAC report shows providers making progress, quality contractor says

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The Medicare Payment Advisory Commission's latest report to Congress was submitted Friday with previously known recommendations for payment levels. But largely lost among the 400-page report also was a body of research indicating that long-term care providers are showing progress in quality improvement activities, said a prominent quality researcher. 

Potentially avoidable hospital readmissions dropped 1% during the study period of 2011-2012, said Andrew Kramer, M.D., the CEO of contract research group Providigm.

“That's the first time they've gone down” in a decade of study, Kramer told McKnight's on Monday. “Obviously, some progress has been made. It starts to say, ‘These are things you can expect.' It's very important from the aspect of partnering [with hospitals].”

Kramer also was enthused about a 2% rise in community discharges: “It's had periods of improvement but been very level for a while. It's probably related to the idea that nursing homes are seeing themselves more as part of the post-acute care continuum and want to release people back into the community. This is very valuable.” 

Kramer added that his group's studies revealed great potential for more improvement in the future. Half of all skilled nursing facility readmissions to a hospital are potentially avoidable, he said.

“It's evident we've made some progress, which indicates we CAN make progress,” Kramer explained. “What it means to providers is they should say, ‘Let's double-down on this, and build it into our QA [Quality Assurance] systems, which is in line with what [the Centers for Medicare & Medicaid Services] is saying.”

Kramer said there was also reason for optimism in three other quality-improvement areas. This applies some degree of pressure on providers, he added: Improvement activities “should find their way into QAPI [Quality Assurance and Performance Improvement] activities. In areas where we know we can have an impact, there will be increasing pressure to do so.”

Beginning in 2018, skilled nursing facilities with high preventable readmission rates will become eligible for reimbursement cuts, he said. This was proposed in the White House budget unveiled earlier this month.


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