AHCA CEO Mark Parkinson

The panel of experts that advises Congress on Medicare-related decisions is once recommending that skilled nursing facilities receive a whack to their payments, and provider advocates aren’t happy about it.

As first reported last month, the Medicare Payment Advisory Commission is advocating the elimination of the fiscal 2020 update to Medicare base payment rates for SNFs. That recommendation was first floated in December. The commission took its final vote on it last week and will share its formal report with Congress in March.

Provider groups didn’t mince words after hearing about MedPAC’s decision, which is nonbinding.

“This recommendation is ridiculous,” Mark Parkinson, president and CEO of the American Health Care Association, told McKnight’s on Tuesday. “Hundreds of nursing facilities across the country have gone bankrupt in the last year. Thousands are potentially at risk. To suggest that we should protect Medicare beneficiaries by making the situation for providers worse is absurd.”

Commissioners said in December that the flat payment proposal for SNFs is based on the industry having adequate access to capital, Medicare margins of 11.2%, and a steady supply of skilled care beds. About 89% of Medicare beneficiaries live in a county with three-plus SNFs, a presentation to commissioners noted.

LeadingAge officials said those numbers don’t account for the full context around Medicaid, fee-for-service Medicare, and privately administered advantage plans. With the industry now preparing for the Patient-Driven Payment Model, any reductions in reimbursement would “further erode” the supply of mission-driven, nonprofit eldercare providers, warned Aaron Tripp, LeadingAge’s VP of reimbursement and financing policy.

“The payment recommendations seem to emanate from Medicare margins that do not tell the complete picture about health services organizations and their financial viability for Medicare beneficiaries,” Tripp said.

Others, such as inpatient rehab facilities and home health agencies, would fare even worse should MedPAC have its way. The panel is urging 5% reductions in payments for both provider types, the American Hospital Association noted in a blog post.