The Medicare Payment Advisory Commission (MedPAC) recommended Thursday that Congress reduce Medicare payment rates for nonemergent hospital visits to be the same as payments made for equivalent services delivered at doctor's offices.
As hospitals acquire physicians' practices in record numbers, more and more routine visits and consultations are taking place in hospital outpatient departments for which Medicare currently pays a higher reimbursement rate than for visits in a traditional office setting.
"America's hospitals are very disappointed with the Medicare Payment Advisory Commission's (MedPAC) recommendations regarding changes in Medicare payment to hospitals," said American Hospital Association President and CEO Richard Umbdenstock in a statement on the AHA's website. "Cutting hospital reimbursement for evaluation and management services in hospital outpatient departments threatens patient access to care that is not otherwise available in a community."
"The cuts to outpatient services in addition to other MedPAC recommended reductions ultimately would jeopardize patient access to unique, vital care," continued Umbdenstock in the statement. "The country continues to experience an economic downturn and more patients than ever are turning to hospitals for their healthcare needs. We urge Congress to reject MedPAC's recommendations regarding the changes to outpatient care reimbursement and provide hospitals with the resources they need to continue their mission of caring for communities."
The AHA reports that MedPAC also recommended:
- Congress provide a 0.5 percent update for ambulatory surgical centers in calendar year 2013, require them to submit cost data and direct the Health and Human Services secretary to implement a value-based purchasing program for ASCs no later than 2016.
- Long-term care hospitals, skilled nursing facilities and inpatient rehabilitation facilities receive a 0 percent market-basket update for fiscal year 2013.
- A 1.0 percent update for the end-stage renal disease prospective payment system
- A 0.5 percent update for hospice providers.
- Revising and rebasing the skilled nursing facilities PPS, which would increase payments to hospital-based SNFs by 27 percent on average, and reducing payments to SNFs with relatively high readmission rates.
The Alliance for Quality Nursing Home Care blasted MedPAC for not providing a cost of living adjustment for skilled nursing facilities and for its proposed guidance on the prospective payment system, saying in a statement that it is "deeply disturbed by MedPAC's continued failure to recognize the obvious link between Medicare and Medicaid in financing SNF care."
"With long term and post-acute care providers across the nation beset by a barrage of federal and state budget cuts already jeopardizing seniors' care, and causing front line care job losses, we are alarmed by MedPAC's recommendation of no market basket increase for FY 2013," said Alan Rosenbloom, the Alliance's president, in a statement. "When combined with the Affordable Care Act requirement that CMS reduce annual market basket increases by productivity adjustment, MedPAC's recommended freeze effectively translates into a cut from current payment levels, not merely a failure to increase payments to account for cost increases."