MedPAC recommends 2019 payment update for hospitals, no PAC update

The Medicare Payment Advisory Commission yesterday recommended that Congress increase Medicare base payment rates for hospital inpatient and outpatient services by 1.25% in 2019, as provided under current law. In other voting, the commission recommended that the Health and Human Services Secretary implement a redesigned skilled nursing facility prospective payment system in 2019 and provide no payment update for SNFs in 2019 and 2020. For other post-acute settings, MedPAC recommended a 5% cut for inpatient rehabilitation facilities in 2020; no update for long-term care hospitals in 2020; a 5% cut for home health agencies in 2019 and a two-year rebasing of the HH payment system beginning in 2020. It also recommended a fiscal year 2019 payment reduction for all four post-acute settings by blending existing relative weights with those from its new post-acute care PPS prototype. Lastly, the commission recommended Congress replace the Merit-based Incentive Payment System for clinicians with a new voluntary value payment program based on population-based measures. The commission also discussed the initial analysis of a congressionally-mandated study examining the impact of the Hospital Readmissions Reduction Program, with a final report due to Congress in June 2018. In comments submitted this week, AHA supported the hospital updates but voiced concerns with the PAC recommendations and called the MIPS proposal “premature and potentially unfeasible.”