The Medicare Payment Advisory Commission on Nov. 7 discussed potential payment reforms for post-acute care. One session reviewed prior MedPAC research that would eliminate the Long-Term Care Hospital Prospective Payment System and pay LTCHs through far lower inpatient PPS payments.
Commissioners also reviewed concurrent LTCH research by the Centers for Medicare & Medicaid Services that would maintain the LTCH PPS but drastically reduce the patient population that would remain eligible for LTCH-level payments. The American Hospital Association strongly opposes both approaches, neither of which has been formally proposed, as they would exclude a significant volume of LTCH-appropriate patients from LTCH-level payment.
Another session sketched out a preliminary site-neutral payment framework for inpatient rehabilitation and skilled nursing cases involving major joint replacement, hip fracture and stroke. The commission plans to continue its research and provide an update on these topics in 2014.
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