MedPAC considers '4-in-1' post-acute care payment system

The Medicare Payment Advisory Commission (MedPAC) is weighing a policy proposal that would bring payments for four post-acute settings into one system, another step in the push to promote site-neutral payments. Four post-acute care (PAC) settings—skilled nursing facilities (SNFs), inpatient rehabilitation facilities, long-term care (LTC) hospitals, and home health agencies—operate under disjointed regulatory and statutory requirements. At its September meeting on Thursday, MedPAC—which makes policy recommendations to CMS—considered bringing those separate silos under one unified payment system. According to Evan Christman, a senior analyst who presented this proposal to the commission, it may be better to qualify payments based on patient characteristics rather than the site of care to “reflect the full range of beneficiaries’ PAC needs.”