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January 18, 2018

ACO roundup: MA beneficiaries more likely to end up in lower-quality nursing homes, study finds

Daily Briefing
    • MIPS would be scrapped—if MedPAC gets its way. The Medicare Payment Advisory Commission (MedPAC) last week voted 14-2 in favor of urging Congress to end the Merit-based Incentive Payment System (MIPS) program and replace it with a new voluntary value-based payment program. Under the voluntary value-based payment program, physicians would join reporting groups that would be compared with other groups on certain performance-based quality of care measures. MedPAC will include the recommendation in its annual report to Congress in March.

    • MA beneficiaries more likely to end up in lower quality nursing homes, study finds.  Individuals enrolled in traditional Medicare were more likely than those in Medicare Advantage between 2012 and 2014 to enter high-quality skilled nursing facilities, according to a study in Health Affairs. Specifically, the researchers estimated that up to 42 fewer individuals in a sample of 1,000 MA beneficiaries would enter a high-quality SNF when compared with a sample of 1,000 fee-for-service Medicare beneficiaries—although the researchers noted that the disparity diminished when comparing beneficiaries enrolled in high-quality MA plans compared with fee-for-service Medicare beneficiaries.

    • Study: Some nursing homes inflate self-reported data to bolster CMS rating. At least 6% of assessed nursing homes between 2009 and 2013 inflated the self-reported parts of their composite score for CMS' Nursing Home Compare ratings, according to a study in Productions and Operations Management. For the study, the researchers assessed the accuracy of the ratings—which are based on self-reported staffing and quality data, as well as an independent on-site evaluation—by comparing ratings issued between 2009 and 2013 with corresponding data on finances and patient complaints submitted to the California Department of Public Health for 1,219 nursing homes in the state. The researchers found that there was little correlation between nursing homes' self-reported quality measures the results of on-site evaluations. In addition, while complaints filed by nursing home patients were comparable among facilities with the same site-evaluation scores, they varied substantially among facilities that shared the same star rating—a finding that according to the researchers indicates a measure of inflation on self-reported data.

    From Advisory Board:

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