The Medicare Payment Advisory Commission (MedPAC) recently recommended that Congress give hospitals a fiscal year (FY) 2011 payment update equal to the rate of change in the market basket index, currently projected at 2.4%, concurrent with implementation of a pay-for-performance program.
But the commission recommended that the Health and Human Services (HHS) secretary reduce the inpatient update by up to 2% in 2011, 2012 and 2013 to reflect what it contends are changes in documentation and coding, which would result in an inpatient update of just 0.4% in FY 2011.
"We're pleased that MedPAC recommended a full market basket update," said Don May, the AHA's vice president of policy.
"However, we are disappointed with the commission's coding offset recommendation, since CMS already has authority to apply an offset and has suggested using a less aggressive transition in its 2010 rule."
In other action, MedPAC recommended that Congress give physicians a 1% payment update in FY 2011, and repeated previous recommendations to increase fee-for-service payments for practitioners who focus on primary care.
At its Jan. 14 meeting, the commission also recommended that Congress provide no payment update in FY 2011 for inpatient rehabilitation facilities, long-term care hospitals, skilled nursing facilities or home health providers.
For home health, the commission said Congress also should direct the HHS secretary to rebase rates to reflect the average cost of providing care; expeditiously modify the home health prospective payment system to protect beneficiaries from stinted or low-quality care; identify groups of beneficiaries most likely to benefit from home health and develop outcomes measures for quality of care; and review home health agencies with unusual patterns of claims and implement safeguards in areas that appear to be high risk. For hospice providers, the commission recommended that Congress provide a 2011 payment update of market basket minus productivity.
MedPAC's recommendations will be included in its March report to Congress.
