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The Medi­care Pay­ment Ad­vi­sory Com­mis­sion may rec­om­mend a 1% update for hos­pi­tal in­pa­tient ser­vices in fis­cal 2012.

In draft rec­om­men­da­tions for fis­cal 2012, the Medi­care Pay­ment Ad­vi­sory Com­mis­sion is con­sid­er­ing a 1% update for hos­pi­tal in­pa­tient ser­vices, a fig­ure that amounts to a full mar­ket­bas­ket update of 2.6% mi­nus a 1.6% ad­just­ment for doc­u­men­ta­tion and cod­ing im­prove­ments. The com­mis­sion also dis­cussed 1% up­dates for hos­pi­tal out­pa­tient ser­vices and physi­cian pay­ments. Al­though com­mis­sion mem­bers dis­cussed fix­ing the sus­tain­able growth-rate for­mula, they did not make any rec­om­men­da­tions on the is­sue (See story, p. 8). The com­mis­sion re­lied on data gath­ered from a tele­phone sur­vey of Medi­care ben­e­fi­cia­ries and pri­vately in­sured pa­tients to as­sess pay­ment ad­e­quacy for doc­tors. In the post-acute sec­tor, the com­mis­sion con­sid­ered rec­om­mend­ing no update for skilled-nurs­ing fa­cil­i­ties, a seg­ment it said has had—and is pro­jected to have—higher Medi­care mar­gins than hos­pi­tals. Hospice providers could see a 1.5% update in 2012, and the com­mis­sion also dis­cussed re-run­ning ear­lier rec­om­men­da­tions to re­form hospice pay­ments so there is an in­cen­tive to re­duce long-stay pa­tients. The com­mis­sion will vote on these and other rec­om­men­da­tions in mid-Jan­uary be­fore re­leas­ing its re­port to Congress on March 15.

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