The most recent meeting of the Medicare Payment Advisory Commission (MedPAC) considered a draft recommendation to reduce payments to home health agencies by five percent in 2019 and a two-year rebasing of the pay system beginning in 2020. In addition, the draft recommendation urges Congress to direct the Centers for Medicare and Medicaid Services (CMS) to revise the payment system to eliminate the use of therapy visits as a factor in payment determinations, in line with rebasing.
“The Congress should reduce Medicare payments to home health agencies by five percent in 2019 and implement a two-year rebasing of the payment system beginning in 2020,” read the recommendation. “The Congress should direct the Secretary to revise the PPS, to eliminate the use of therapy visits as a factor in payment determinations, concurrent with rebasing.”
MedPAC believes this will lower spending without affecting provider ability to serve beneficiaries, though no evidence of that was presented. MedPAC claims the two recommended changes, reducing payments and eliminating the use of therapy visits as a factor in payment determinations, will be budget neutral and redistributive.
The Medicare advisers outlined an interim post-acute care payment system for CMS to implement until a unified system is put in place in 2021, as is required by the IMPACT Act. The interim system would keep total payments to each post-acute care setting at set levels, while redistributing pay across conditions within each sector.
The blended system would feature redistribution based on patient mix and therapy practices, with payments increasing to nonprofits and hospital-based providers, while falling in the case of for-profit providers.
All of the draft recommendations are expected to come for a vote in January and many commissioners indicated they would support the recommendations.
You can read the entire transcript HERE. The home health portion begins on page 236.
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