The Medicare Payment Advisory Commission (MedPAC) is considering a policy that would bring payments for four post-acute settings into one system. This is another step to promote site-neutral payments.
Four post-acute care (PAC) settings—skilled nursing facilities (SNFs), inpatient rehabilitation facilities, long-term care (LTC) hospitals and home health agencies—presently work under disjointed regulatory and statutory requirements. MedPAC recommends policies to CMS and in a meeting, it considered bringing these separate silos under a unified payment system.
According to Evan Christman, a senior analyst, the presenter of this proposal to the commission, it could be better to qualify payments based on patient characteristics instead of site of care in order to reflect the full range of beneficiaries that PAC needs.
This proposal would split all PAC providers into two tiers. First, or “general” tier would include majority of patients. The second, or “specialized” tier would include patients with the highest care needs, using a list of conditions. Medicare could update these categories over a period of time with changes in clinical needs, provider capacity and health technologies.
As value based care solutions are getting popular in healthcare these are some new developments regarding the payment system.