The AHA this week applauded the Medicare Payment Advisory Commission’s draft recommendation to provide positive updates for the inpatient and outpatient prospective payment systems in 2019, noting the commission’s projection that the overall hospital Medicare margin will fall to negative 11% in 2018. “Indeed, according to the MedPAC chart book, Medicare has not fully covered the costs of caring for Medicare beneficiaries since 2002,” wrote Ashley Thompson, AHA senior vice president for public policy analysis and development. “…We urge the Commission to acknowledge that Medicare payments are inadequate and that a full market-basket increase for inpatient and outpatient hospital services is absolutely necessary.” In other comments, AHA again urged the commission not to use a proposed blend of new and current weights to calculate 2019 and 2020 payments under its prototype post-acute care prospective payment system, citing concerns with the proposal’s feasibility. The association also urged MedPAC to support the 2019 market basket increases for long-term care hospitals and hospital-based skilled nursing facilities under current law, rather than proposals to eliminate them, noting the “significant underpayment” of LTCH site-neutral cases and “extremely negative” Medicare margins of hospital-based SNFs.

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