MedPAC to Congress: Advance site-neutral cost

MedPAC to Congress: Advance site-neutral cost

Medicare cost advisers voted Thursday to advocate that Congress transfer ahead with site-neutral Medicare cost for sure well being care providers.

Why it issues: Congress doesn’t need to hearken to the Medicare Cost Advisory Fee’s suggestions, however the recommendation may add some juice to House discussions on site-neutral funds.

The small print: MedPAC’s suggestion requested Congress to extra intently align charges throughout doctor workplaces, ambulatory surgical facilities and hospital outpatient departments for 66 particular cost classifications outlined in Medicare’s outpatient cost system — however solely when doing so doesn’t pose a threat to affected person entry.

  • MedPAC employees mentioned throughout Thursday’s session that they didn’t count on the draft suggestion to have any direct impact on program spending, however famous that site-neutral cost may discourage supplier consolidation and decrease spending not directly.
  • Beneficiaries may even see decrease price sharing for some providers, and better price sharing for others because of website neutrality, employees added.

Price noting: The advice handed unanimously throughout a revote a uncommon twist for MedPAC after one commissioner initially abstained.

  • Commissioners decided that the unique vote was taken on incorrect suggestion language which didn’t make clear that Congress ought to solely align cost charges for chosen providers which are “protected and applicable to offer in all settings.”
  • Robert Cherry, the one commissioner who initially abstained, works for UCLA Well being.

  • “The problem with website neutrality as is at the moment constructed within the chapter is that it could result in unintended penalties… (for) particular person sufferers who might profit from a extra resource-intense setting corresponding to a hospital outpatient division,” he mentioned.
  • Commissioner Lynn Barr, who has a background in rural well being, additionally raised issues previous to voting that the coverage change may harm affected person entry to care in rural areas.

Actuality verify: “That is in all probability like a poster baby coverage for ‘let’s not let the right be the enemy of the great,’ mentioned Commissioner Amol Navathe, an affiliate professor of well being coverage and drugs on the College of Pennsylvania. “Attending to an ideal coverage goes to be not possible.”

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