In it’s June 2019 report, the Medicare Payment Advisory Commission (MedPAC) provided additional detail on what a unified post-acute care payment model might look like.
MedPAC has presented the idea of a unified payment model for all post-acute care providers in the past. Such a system would include home health agencies, skilled nursing facilities, in-patient rehabilitation facilities and long-term care hospitals.
The June report outlines a recommendation for a stay-based model that would involve a 5% Medicare payment reduction for home health agencies.
MedPAC also questions the accuracy of functional assessment data in post-acute care.
Analysis showed instances of beneficiaries discharged from one post-acute care setting then admitted to a different post-acute setting demonstrating “substantially different” functional scores, according to the report.
There were also disagreements between items used for payment when compared to separate assessment items used for quality reporting.
“Our analyses and past experience with [post-acute care] providers responding to payment incentives raise questions about whether this information should be relied on for establishing payments. Even if the data appeared consistent, we question whether Medicare should base payments on a factor of care that is firmly in a provider’s control,” the report states.