Home Health & Hospice

MedPAC Drafts 2011 Recommendations

Homecare Insider, January 3, 2011

The Medicare Payment Advisory Commission (MedPAC) met on December 3, 2010 to discuss their 2011 recommendations regarding healthcare, and much of the discussion regarded home health and hospice. Regarding home health, MedPAC voiced that homecare represents good access to care and demonstrates quality improvement, along with much growth in the industry with concentrated growth in Texas and Florida. Concerns voiced by MedPAC included what they consider to be excessive profit margins, the need for clinically-focused outcomes measures, and rebasing of rates, among other issues. MedPAC’s draft recommendations included:

  • A 2 year rebasing of rates beginning in 2012 and an elimination of the market basket update in 2012
  • A revision of the case-mix system to rely on patient characteristics and eliminate therapy visits as a payment factor
  • Per episode home health co-pay for episodes not preceded by a hospital or post-acute stay and for beneficiaries who are not dually eligible
  • A moratorium on enrollment of new agencies and payment suspension in high risk fraud areas
  • A narrower window for face-to-face physician encounters
  • Face-to-face physician encounter requirements for recertifications

MedPAC will meet again this month to vote on recommendations that they will make to Congress in a March 2011 report.

Complete transcripts of MedPAC meetings are available on www.medpac.gov