News, Skilled Nursing Facility

MedPAC makes recommendations for FFS payment updates in annual report

In their annual report to Congress, the Medicare Payment Advisory Commission (MedPAC) made policy recommendations for nine provider sectors in fee-for-service (FFS) Medicare, including recommendations against raising payment rates for both skilled nursing facilities (SNFs) and home health agencies. MedPAC recommends that Congress not increase base payment rates for SNFs in 2020 and suggests that Congress reduce base payment rates for home health agencies by 5 percent for 2020.

MedPAC also comments on the status of the Medicare Advantage (MA) program, which showed enrollment numbers growing by 8 percent between 2017 and 2018. The commission still has concerns about the program’s star rating system, which the commission says awards unwarranted bonus payments. To address this issue, the commission is considering using encounter data as the source of quality metrics in MA and moving to market areas as the reporting unit.

The full report includes recommendations to replace hospital quality payment programs with a new streamlined program and an update on incentives for prescribing opioid and non-opioid pain treatment under Medicare’s hospital inpatient and outpatient payment systems.