The issue of wasteful or “low-value” health care has attracted a lot of attention in the policy community because it represents an opportunity to reduce health care spending while maintaining or even improving quality for patients. The Commission has been working on ways to measure the incidence of low-value care within Medicare. The most recent iteration of this work, which was presented at our April meeting [link to presentation], contributes to the evidence that Medicare beneficiaries are receiving a significant amount of low-value care.
MedPAC’s March 2015 report continues the Commission’s focus on increasing support for primary care with a recommendation to create a per beneficiary payment for primary care providers.
MedPAC’s March 2015 report continues the Commission’s focus on site-neutral payments with a recommendation to eliminate differences in payment rates between inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) for selected conditions.
This year, MedPAC examined coding differences between beneficiaries in FFS Medicare and those enrolled in MA plans. We found that beneficiaries in MA had more growth in risk scores than beneficiaries who had remained in FFS. And those differences grew the longer enrollees stayed in MA.
The hospital readmission reduction program (HRRP), established under the Patient Protection and Affordable Care Act of 2010, has helped to reduce hospital readmissions. Since the introduction of the HRRP, readmission rates have fallen for Medicare beneficiaries across all types of hospitals, including those seeing higher shares of poor patients.
Today, MedPAC releases its March 2015 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s analyses of payment adequacy in fee-for-service (FFS) Medicare and provides a review of Medicare Advantage (MA) and the prescription drug benefit, Part D.
Today MedPAC posted a comment letter to CMS on the list of Medicare quality measures under consideration for use in Medicare’s quality reporting or value-based purchasing programs. This year’s “list of measures under consideration” is a 329-page document listing hundreds of quality and resource use measures. Under the statute, CMS may consider including any of these measures during upcoming rule-making for its quality program. The list does not include the dozens of measures already adopted for Medicare’s quality programs, only potential new measures.
The Commission released a report today finding that Medicare’s payments to skilled nursing facilities (SNFs) for therapy and nontherapy ancillary services are the least accurate they have been since 2006, despite Medicare’s numerous revisions to the payment system during this period.
Today, the Commission released a report to the Congress assessing the impact of Medicare’s home healthcare payment rebasing on beneficiary access and quality. The report was mandated by the Patient Protection and Affordable Care Act, which also created the rebasing policy. The report’s primary finding is that rebasing – in other words, reducing the base payment rate for home healthcare – will not threaten beneficiary access to home health services or compromise quality of care.
Each year during its update process (read this post for more on that), the Commission examines Medicare’s payments to hospitals for inpatient and outpatient care. As part of this analysis, MedPAC compares Medicare’s payments to hospitals’ costs to determine a Medicare “margin.” For several years, these margins have been negative, indicating that on average, Medicare’s payments are less than hospitals’ costs. Some would argue that negative margins are an indication that Medicare needs to increase its payments to cover hospital costs. A different way to think about the issue is to ask whether hospitals’ costs have to be as high as they are and whether hospitals have the ability to control costs. Said differently, we wondered, “Are hospital costs immutable?”