Medicare payments for post-acute care providers would be determined based on a small number of risk-adjusted, claims based quality measures under a recent proposal by the Medicare Payment Advisory Commission.
MedPAC revealed that it’s drafting a value-based payment proposal that would pay providers based on their quality of care during a commission meeting last week, Bloomberg Law reported. The proposal would apply to four types of post-acute care providers: nursing homes, in-home care, inpatient rehab facilities and long-term acute care hospitals.
Under the proposal, measures that would determine pay levels would include hospitalizations, successful discharge into the community, and Medicare spending per beneficiary, according to commission documents.
Additionally, under the proposal, a 5% withhold of funding providers would receive would be used to fund incentive payments for providers who meet performance goals.
The commission said Medicare needs to tie its payments to quality of care to incentivize improvement and a unified prospective payment system across the four post-acute care settings will require a uniform value-incentive program.
It also noted that current value-based payment programs for skilled nursing facilities and home health agencies don’t meet the commission’s principles, saying neither program has a small set of population-based outcome measures the gauge quality, patient experience and resource use.
The commission plans to study and model the effects of the proposal and present its findings at a later date, the report stated.