Medicare panel seeks enhanced payments, eligibility for the PACE program

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Make therapy caps lower, streamline review process, MedPAC chairman urges House committee
Make therapy caps lower, streamline review process, MedPAC chairman urges House committee

Program of All-Inclusive Care for the Elderly providers should be paid more generous Medicare Advantage rates, according to a payment panel. The Medicare Payment Advisory Commission also called for changes that would allow people younger than age 55 to participate in the program, which targets dual eligible seniors.

In its June 15 report to Congress, the commission said that PACE spending is actually higher than if beneficiaries had remained in traditional fee-for-service programs. In the past, PACE has been shown to reduce hospitalizations and nursing home stays among dually eligible Medicare and Medicaid beneficiaries, but it's currently experiencing lower than projected enrollment rates. The demonstration program was enacted to give nursing home eligible populations a community-based option for long-term care services.

The commission's semi-annual report to Congress has two general goals: preventing unexpectedly high out-of-pocket costs for beneficiaries, and creating incentives that encourage beneficiaries to make better decisions about healthcare services.

Click here to read Medpac's recommendations to Congress.