House panel hears testimony on site-neutral payments, potential for Medicaid cuts to providers

The Medicare Payment Advisory Commission is nearing completion of its prototype for a unified, site-neutral post-acute payment, the group said during a meeting on Thursday.

The new system would focus on patient characteristics, rather than type of post-acute care facility, and correct some of the “shortcomings” of the current prospective payment systems, MedPAC said. The prototype also includes high-cost and short-stay outlier policies.

The unified system would be used for skilled nursing facilities, home health agencies, inpatient rehabilitation facilities and long-term care hospitals, but would have the most adverse effects on IRFs and LTCHs because the patients treated in these facilities can also be treated in lower-cost settings, Modern Healthcare reported.

Some MedPAC members suggested the Centers for Medicare & Medicaid Services test the system with volunteer post-acute providers, and that the agency shorten the timeline for implementing the new system.

MedPAC will vote on a the prototype system in April, and submit a final report to Congress for consideration in June.