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MedPAC finalizes 2014 recommendations for post-acute care

January 11, 2013

At a two-day meeting concluding today, the Medicare Payment Advisory Commission recommended no marketbasket update for inpatient rehabilitation facilities, long-term care hospitals and home health providers in 2014. The commission also restated its prior recommendation for a two-year rebasing of the HH payment system starting in 2013, rather than the four-year rebasing starting in 2014 mandated by the Patient Protection and Affordable Care Act. During the post-acute sessions, commissioners discussed the ongoing need for a patient-centered approach to determining the type and amount of post-acute care for beneficiaries, repeatedly noting the potential future benefit of bundling hospital and post-acute payments. MedPAC approved 2014 recommendations for skilled nursing facilities last month, which call for no marketbasket update and rebasing the SNF prospective payment system to better align payments with costs, which would result in an estimated 4% payment reduction in the first year. The commission projects 2013 Medicare margins of 11.8% for HH, 11%-14% for SNFs, 8.5% for IRFs and 5.9% for LTCHs.