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The Medicare Payment Advisory Commission started work last week on creating a unified payment model that could change the way post-acute care providers receive Medicare reimbursements.

The new MedPAC plan would pay skilled nursing facilities, inpatient rehabilitation facilities, home health agencies and long-term care hospitals with one unified system. Currently the four are paid separately.

At a meeting last Thursday, MedPAC covered the plan’s initial format. Up for debate is whether payments rates would be based on a beneficiary’s health conditions compared to the type of facility where they received treatment. The potential plan would be split into two models; one for SNFs, rehab facilities and LTC hospitals which would include an add on for non-therapy ancillary services like ventilator services and drugs, and one for home health agencies that would not pay for ancillary services.

MedPAC is required to create a plan for a new post-acute payment model as part of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, which was passed last year. A report on the prototype plan is due to Congress by June 30, 2016.