A rebasing impact report [PDF] issued by the Medicare Payment Advisory Commission (MedPAC) contains data and methodologic flaws, the Partnership for Quality Home Healthcare (PQHH) maintains.
The Affordable Care Act (ACA) required the report to be issued by Jan. 1. Lacking sufficient claims data from calendar year 2014, MedPAC used Medicare data from 2001 to 2012 to build its projections—one of many issues ciited by PQHH. Yet in their report, the MedPAC commissioners said that findings were “consistent with our prior work” and stated: “Experience suggests that the small [ACA] rebasing reductions will not change average episode payments significantly. Home health agency margins are likely to remain high under the current rebasing policy, and quality of care and beneficiary access to care are unlikely to be negatively affected.”
PQHH disagrees. “In mandating that MedPAC issue a rebasing impact report by Jan. 1, 2015, the ACA has forced MedPAC to produce an analysis even though [the Centers for Medicare & Medicaid Services] has confirmed that ‘sufficient claims data…[are] not available.’ Due to this problem and other methodological issues, the ACA-mandated report does not provide the accurate and comprehensive information that policymakers need,” Eric Berger, CEO of PQHH, said in a statement. “As a result, the partnership urges lawmakers to continue seeking alternatives to the ACA’s deep rebasing cut and to continue advancing policy solutions that protect patients, increase Medicare efficiencies and reduce spending.”
Such alternatives, PQHH says, include:
- The Securing Access Via Excellence Medicare Home Health Act (H.R. 5110). This bill would replace the ACA rebasing cut beginning this year, with budget neutrality established via a value-based purchasing program that would reduce hospital readmissions with incentives that reward positive outcomes.
- The Bundling and Coordinating Post Acute Care Act (H.R. 4673). This legislation would establish bundled payments for post-acute care services and use post-acute care coordinators and their networks of post-acute care providers to manage care under site-neutral bundled payments.
- The Skilled Home Health Integrity and Program Savings. This proposal, according to PQHH, targets Medicare fraud and abuse by preventing the payment of aberrant claims, strengthening the claims review processes, improving participation standards and establishing temporary entry limitations to prevent excess growth.