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MedPAC Debates Reduced Home Payments for Sequential Stays

Posted on Friday, March 16, 2018 1:07 PM

MedPAC has been tasked with analyzing the Medicare System and offering recommendations to Congress for how it can function more cost effectively.  One of their ongoing efforts has been studying how to change the post-acute payment model so that reimbursements are rationalized across provider types.  If a home health agency, a skilled nursing facility and inpatient facility are all caring for a patient in the same manner, then they should also be receiving similar Medicare payments.

At a recent meeting in Washington D.C. the commission reviewed sequential stays.  Sequential stays occur when a patient leaves a post-acute care facility and reenters another one soon after. 

“One of the primary issues is that the cost of delivering care can change as a patient’s needs change. Someone coming out of the hospital and entering home health care might have acute conditions and need intensive services during an initial 60-day care episode. That patient’s condition might then improve but still call for ongoing home health care, so the subsequent episode would be more profitable to the provider even if Medicare continues paying the same amount. This could incentivize providers to keep patients unnecessarily, to juice the bottom line.”

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