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MedPAC unveils new value-based model plan for post-acute care

Value-based model watchers may be interested in an outline in the new MedPAC report, required by the Consolidated Appropriations Act of 2021, for a proposed value-based program for a post-acute care value incentive program, aka PAC-VIP.
Along with the payment and other Medicare recommendations the Medicare Payment Advisory Commission aka MedPAC makes in its semi-annual report, the March 2022 edition lays the broad strokes for a proposed value-based model. 
The program, if picked up by the Center for Medicare and Medicaid Innovation (CMMI), would reward home health agencies (HHA), skilled nursing facilities (SNF), inpatient rehabilitation facility services (IRF) and long-term care hospitals (LTCH) based on performance on a small number of measures, such as successful discharge to the community and Medicare spend per beneficiary.

Also, in keeping with the health equity focus reflected in the recent ACO REACH program, MedPAC proposes that “providers in peer groups with patient populations at high social risk would receive larger adjustments for attainments in quality compared with other providers” (PBN 3/21/22).

“Changes in post-acute care were early targets of many ACOs, recognizing that PAC providers were responding to volume-based incentives to keep patients longer for services,” explains Theresa Hush, CEO of Roji Health Intelligence, a consultancy and data registry in Chicago.
The program also fits with several recent CMS efforts “to evaluate profitability and quality in nursing home settings,” Hush adds. “Developing a VIP program is clearly an early step to ensure that there are meaningful measures of quality, with funds attached, to get post-acute providers aligned with value-based care.”
The feature of the MedPAC report that will probably most interest providers, a proposed 0% payment adjustment for 2023, is covered in the latest issue of Part B News (subscription required)
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