The notion that hospitals can reduce readmissions, and that punishing them for “excess” readmissions will get them to do that, became conventional wisdom during the 2000s on the basis of very little evidence. The Medicare Payment Advisory Commission (MedPAC) urged Congress to enact the Hospital Readmissions Reduction Program (HRRP) beginning in 2007, and in 2010…
The notion that hospital readmission rates are a “quality” measure reached the status of conventional wisdom by the late 2000s. In their 2007 and 2008 reports to Congress, the Medicare Payment Advisory Commission (MedPAC) recommended that Congress authorize a program that would punish hospitals for “excess readmissions” of Medicare fee-for-service (FFS) enrollees. In 2010, Congress…
Medicare ACOs are designed to slow growth in Medicare spending and improve the quality of care delivery. Since the first ACOs were established in 2012, there has been a persistent question of whether the population health management and wellness measures employed by ACOs will result in fewer inpatient stays and lower hospital revenue. Can ACO participation be worth the financial risk for inpatient hospitals? Ultimately, no hospitals would be willing to join an ACO if lower revenue put the…
The Medicare Shared Savings Program (MSSP), now in its sixth full performance year, is at a significant crossroads. In creating the MSSP, Congress envisioned that Medicare accountable care organizations (ACOs) could moderate Medicare spending and improve quality of care by providers taking greater responsibility for costs and quality. While MSSP ACOs have clearly improved the…
Medicare accountable care organizations (ACOs) operating under two-sided financial risk arrangements save the federal healthcare program more than one-sided risk organizations. But policymakers must address financial incentives, benchmarks, and other issues to ensure two-sided risk ACOs continue to generate savings, the Medicare Payment Advisory Commission (MedPAC) recently reported. “Medicare ACOs were created to help moderate…
A stronger payment incentive for certain coordinated care organizations could be the key to reducing healthcare costs, according to the primary group that advises Congress on Medicare policy. At a public meeting last week, members of the Medicare Payment Advisory Commission (MedPAC) discussed possible tweaks and changes to accountable care organizations (ACOs), including expansion of a major bonus incentive…
The Medicare Payment Advisory Commission has released its semiannual report on Medicare payment policy to Congress, which includes a recommendation to axe the Merit-based Incentive Payment System. MedPAC said it decided MIPS should be eliminated after a two-year deliberative process. “We first examined options for improving MIPS as it was implemented, and we provided constructive…
WASHINGTON — Members of an influential federal advisory panel sparred here today over a recommendation that would direct Medicare to scrap its fledgling Merit-based Incentive Payment System (MIPS) and instead implement a new approach for tying reimbursement to judgements about value of care. The Medicare Payment Advisory Commission (MedPAC) voted 14 to 2 in favor…
