MedPAC gives green light to post-acute prospective payment system

A site-neutral, unified payment system for post-acute care would be a “feasible” way to break down barriers between care settings, the Medicare Payment Advisory Commission said last week.

In its January 14 meeting, MedPAC touted the ability of a unified PPS to span across the care continuum and “correct some shortcomings” and “systematic biases” in the current policies. Payment increases are expected for patients requiring ventilator care, severe wound care or critical chronic conditions, MedPAC reported. Orthopedic services, non-stroke neurology conditions and the “least frail” patients are among potential payment decreases.

Centering a payment system around patient characteristics, rather than care settings, would also “dampen incentives” for facilities to selectively admit some patients over others, MedPAC noted.

Level of payments, an adjuster for low-volume, isolated providers and a high-cost outlier policy are the next topics to be tackled in the group's PPS discussions, slated to take place in March. The PPS report will be finalized in April and presented to Congress in June, MedPAC said.

Although provider groups have pushed for site-neutral payment models in the past, Congress may not choose to follow MedPAC's recommendations.

Last week's MedPAC meetings also saw unanimous votes on other recommendations, including a payment rate freeze, and 2017 payments for physicians, ambulatory surgical centers, home health programs and inpatient rehabilitation facilities, Bloomberg reported.