MedPAC: Current payments encourage 'unnecessary' post-acute care

Federal officials may have missed out on saving as much as $11 billion over the past seven years by not implementing the Medicare Payment Advisory Commission's recommended post-acute payment updates, the group said on Wednesday.

The estimated “cost of past inaction” on MedPAC's update recommendations — which include eliminating market basket updates for skilled nursing providers — were illustrated in the commission's most recent report to Congress.

“The [post-acute] industries, on the whole, would still be profitable,” the commission said. “They have historically demonstrated resilience in reconfiguring their service mix and costs in response to changes in payment policy.”

By not lowering post-acute payments or revising the skilled nursing payment system, the Centers for Medicare & Medicaid Services and Congress are “sending the wrong price signals,” the report argues.

“Current payments encourage providers to furnish unnecessary care and to prefer to treat some patients over others,” the report reads.

MedPAC added that “revised payment systems will give providers valuable experience in managing care under payment systems that tailor payments to the care needs of patients.”

The report also details CMS' progress on collecting quality reporting and assessment data, and its “less successful” attempts at implementing a value-based purchasing program in each post-acute setting. The panel urged Congress and CMS to implement its recommendations this year.

MACPAC, a commission dealing with Medicaid and CHIP payments, also issued its report to Congress on Wednesday. Among the group's recommendations is a call for lawmakers to strengthen oversight and data collection regarding beneficiaries' access to care.