Pay equality endorsed again

Congress should consider site-neutral payments for post-acute providers as a way to cut federal healthcare spending, a Medicare Payment Advisory Commission official told a House panel in December.

Inpatient rehabilitation facility payments are as much as 42% higher than skilled nursing facility payments, even though both provider types treat similar patients, MedPAC Executive Director Mark Miller, Ph.D., told the Health Subcommittee of the House Committee on Energy and Commerce. 

In its June 2014 report to Congress and in subsequent work, MedPAC has analyzed certain services — such as therapy after joint replacement — that could be good options for equal payments.

All the services “were safely provided a majority of the time in the lower-cost SNF setting,” Miller stated in written testimony.

Long-term care provider associations are in support of the policy, but rehab provider groups and some consumer advocates are not, saying inpatient rehab facilities are more capable of caring for higher acuity patients.