Bundled post acute payment plan could cost SNFs

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Nursing homes' loss would be home healthcare's gain under a controversial plan that would create site-neutral payments for post-acute care.

Though the threat of bundling post-acute care payments has loomed for more than six years, the president and the House both have placed post-acute care bundling in their respective budget requests, according to Rep. David McKinley (R-WV). On Tuesday, he urged providers to rally behind the proposal embodied in his proposed Bundling and Coordinating Post-Acute Care (BACPAC) Act, claiming funding cuts have threatened 40% of all home health agencies across the country, especially in rural areas.

McKinley, who made his comments in an address to the Alliance for Home Health Quality and Innovation, said BACPAC would save Medicare between $20 billion and $30 billion over 10 years without cutting payments to providers.

Nearly every time the bundling issue has been raised, the American Health Care Association has publicly opposed it, most recently at a hearing on Capitol Hill in mid-April. The group argued that BACPAC would “introduce a new type of entity between the payer, patients and the provider that would create strong incentives to siphon away valuable resources that could otherwise be used in direct patient care.”

Under the BACPAC proposal, risk-based, per beneficiary bundled payments would be tendered with an acute care coordinator. The bundled payments would not include physician services, outpatient therapies, outpatient ambulance, hospice and outpatient hospital services.