MedPAC releases draft recommendations for hospital payment
Group also suggests changes for outpatient physician offices
Topics: Medicare, Reimbursement, Finance
December 19, 2011
Inpatient and outpatient reimbursement to hospitals that treat Medicare patients would increase by 1% in fiscal year (FY) 2013, according to draft spending recommendations released Thursday by the Medicare Payment Advisory Commission (MedPAC).
The recommendations also suggested that the HHS secretary be authorized to reduce payments for evaluation and management office visits in hospital outpatient departments to the rate of free-standing physicians' offices.
MedPAC's other recommendations include:
- Eliminating a market basket increase for skilled nursing facilities (SNFs) in 2013;
- Changes to a prospective payment system for SNFs in 2013;
- A "rebase" of Medicare payments to SNFs in 2014, which would include an "initial reduction of 4% and subsequent reductions over an appropriate transition until Medicare's payments are better aligned with providers' costs;"
- A 0.5% increase in payments for ambulatory surgical center services in 2013; and
- An overhaul of the sustainable growth rate formula, which determines Medicare physician reimbursements, that would establish a 10-year fee schedule that freezes primary care payment rates and cuts other provider rates by 5.9% for three years before also freezing those payments.
The draft recommendations do not take into account automatic Medicare spending cuts that would take effect in 2013 under the recent budget deal. MedPAC is expected to vote on the final recommendations in January and report them to Congress in March (Norman, CQ HealthBeat, 12/15 [subscription required]; Reichard, CQ HealthBeat, 12/15 [subscription required]).
You May Also Like
-
September 16, 2011
Study
| Health Care Advisory Board
This study explores the major forces shaping hospital margins across the next decade and provides best practices for developing a comprehensive margin improvement strategy.
-
About Advisory Board
| Health Care Advisory Board
The Medicare Breakeven Project offers ongoing support and guidance to hospitals and health systems preparing for the challenges of a market characterized by ever-greater reliance on publicly insured volume.
-
About Advisory Board
| Health Care Advisory Board
The Medicare Payment Innovation Project is a peer working group for providers who are preparing for or participating in Medicare demonstrations, pilots, or programs that evaluate emerging payment models.
More from the Daily Briefing
View all
