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MedPAC Explores Encouraging Patients to Seek the Best Post-Acute Care Providers

Posted on Friday, March 16, 2018 1:12 PM

“The Medicare Payment Advisory Commission (MedPAC) said helping Medicare beneficiaries select higher quality post-acute care (PAC) providers should be a goal of MedPAC, as it would improve beneficiary health outcomes and lower program costs.”

Hospitals are charged with providing patients with a list of post-care hospital needs and must also give the patient a list of home health agencies and skilled nursing facilities if needed.  At this time, hospitals are not required to provide quality measures in their recommendations.  As a result, patients are often accessing lower quality post-acute care members because they do not have all the necessary information to make an informed decision. 

“About 40 percent of hospital discharges resulted in the use of post-acute care in 2016”, according to a MedPAC analysis of Medicare data.

 

Medicare Expenditures

Number of Providers

Skilled nursing facility

$29.1 billion

15,307

Home health agencies

$18.1 billion

12,204

Inpatient Rehab facilities

$7.7 billion

1188

Long-term acute care hospitals

$5.1 billion

407

MedPAC staff recommended two options to assist patients in accessing post-acute care providers. Those options are a Flexible model and the Prescriptive model.

Under the Flexible model, hospitals would collect, review and maintain data on post-acute care facilities on their own. This would allow them to develop quality standards specific to each patient’s needs. The drawback, is that the standards would be unique to each individual hospital, creating multiple standards and measures. 

In the Prescriptive model, CMS would define the quality measures for post-acute care providers and distribute a list to patients and hospitals of qualifying PAC’s. This would ease the burden on patients and hospitals, however, it may require setting national and local standards. 

Source: NAHC Report


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