Law­mak­ers leery of pro­posed Medi­care cuts

Modern Healthcare - - LATE NEWS - —Mara Lee

The Medi­care Pay­ment Ad­vi­sory Com­mis­sion last week ar­gued that the fed­eral gov­ern­ment could have saved $11 bil­lion by now if it had heeded re­peated pro­pos­als to cut or freeze pay­ments to skilled-nurs­ing fa­cil­i­ties, in­pa­tient re­ha­bil­i­ta­tion cen­ters, long-term acute-care hos­pi­tals and home health agen­cies.

“Con­strain­ing unit prices could cre­ate pres­sure on providers to con­trol their own costs and be more re­cep­tive to new pay­ment meth­ods and de­liv­ery re­form sys­tems,” MedPAC Ex­ec­u­tive Di­rec­tor Mark Miller told a House Ways and Means sub­com­mit­tee, sug­gest­ing that prof­its off of Medi­care pa­tients are ex­ces­sive. Home health agen­cies and skilled-nurs­ing fa­cil­i­ties see prof­its ex­ceed 15% on aver­age and have for a decade, he added.

Miller’s re­marks got a cool re­cep­tion. Rep. Peter Roskam (R-Ill.) said an in­pa­tient re­hab fa­cil­ity in his district is a crown jewel, and that of­fi­cials there have told him their over­all mar­gin is only 3.6%, and they lose 20 cents on the dol­lar on Medi­care pa­tients. Miller re­as­sured him that there would be ex­tra pay­ments to the out­lier pool to make up for ratch­et­ing down the rate across the sec­tor.

MedPAC has asked Congress to cut Medi­care pay­ments to home health agen­cies and in­pa­tient re­hab fa­cil­i­ties by 5% as well as freeze pay­ments to skilled-nurs­ing fa­cil­i­ties for two years dur­ing pay­ment re­form.

MedPAC does rec­om­mend rate in­creases for some cat­e­gories, no­tably, 1.85% for hos­pi­tals. Miller tes­ti­fied that it is “im­per­a­tive” for Medi­care to re­strain pay­ment rates for hos­pi­tals.

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