The Medicare Payment Advisory Commission this week discussed several draft recommendations for Congress, which it could vote on in January. The proposals would make recommendations to increase payment rates for hospital inpatient and outpatient services by 1.25% in 2019; eliminate the 2019 and 2020 payment updates for skilled nursing facilities and the 2019 updates for long-term care hospitals and ambulatory surgical centers; and reduce the 2019 payment rates for inpatient rehabilitation facilities and home health agencies by 5%. The commission also discussed a proposal to direct the Health and Human Services Secretary to begin to base Medicare payments to post-acute care providers on a blend of the setting-specific relative weights and unified post-acute care prospective payment system relative weights in fiscal year 2019. The commission also could vote on recommendations to replace the Merit-based Incentive Payment System for clinicians with a new voluntary value payment program based on population-based measures; increase 2019 payment rates for physicians and other health professional services by the amount specified in current law; and require ASCs to report cost data.

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