MedPAC Holds January Public Meetings

Background
On Thursday, January 11, 2018, the Medicare Payment Advisory Commission (MedPAC) met as scheduled for their first public meeting of 2018 in Washington, DC. The purpose of this and other public meetings of MedPAC is for the commissioners to review the issues and challenges facing the Medicare program and then make policy recommendations to Congress.

During this meeting, MedPAC staff assessed payment adequacy and updating payments for skilled nursing facilities and home health services as well as voting to replace the Merit-based Incentive Payment System (MIPS) with a more voluntary approach under a new program.

What You Need to Know
After reviewing the summary of the January MedPAC meeting, we identified the following as being of interest to SNF providers:

> MedPAC projects SNF Medicare FFS margins to be 9% for FY 2018.

> As part of their Draft 2018 Recommendations to Congress, MedPAC voted to approve to following:

  • Elimination of the market basket update for SNFs for FY2019 and FY2020;
  • Direct the Secretary to implement a redesigned prospective payment system (PPS) inFY2019 for SNFs; and

Direct the Secretary to report to the Congress on the impacts of the revised PPS and make any
additional adjustments to payments needed to more clearly align payments with costs in FY2021.

> If Congress chooses to adopt these recommendations, MedPAC projects:

  • A $750 million to $2 billion decrease in payments for FY 2019;
  • A reduction in the disparity of Medicare margins between providers;
  • Increased access to services for medically complex beneficiaries; and
  • A variable impact on individual providers based on their mix of cases and current practice patterns.

Preferred Therapy Solutions (PTS) will continue to monitor the activity and recommendations made by MedPAC. What is clear based on their January meeting is that MedPAC supports replacing the current SNF-PPS with a re-designed payment model which more closely aligns payment with cost. This further supports our belief that the Resident Classification System (RCS-I) will be implemented this October. PTS has fully analyzed RCS-I and is prepared to meet the challenges we will all face under this new payment model.

As your Rehabilitation Partner, Preferred Therapy Solutions continues to collaborate with your facility. If you have any questions, please contact Maria Maggi, Vice President of Compliance: mmaggi@preftherapy.com