Yes. A unified value-based incentive program for post-acute care providers is recommended with a possible 5% withhold. MedPAC, the Committee that advises Congress on Medicare, is building on their previous work for the unified prospective payment system across four post-acute settings.
The unified value-based incentive program would tie quality to payments for skilled nursing facilities, home health services, inpatient rehabilitation facilities and long-term care hospitals.
The proposed incentive program includes a number of risk-adjusted claims-based measures including all-condition hospitalization within the post-acute care stay, successful discharge to the community and Medicare spending per beneficiary. For more details see our MarketScan Report September 18, 2019: The Focus on Post-Acute Spending Becomes Front and Center with New Payment Models.
The incentive program also accounts for social risk factors by comparing providers with similar shares of dual-eligible beneficiaries. A 5% withhold would fund the incentive payments. But, the Commission said that the number might change based on feedback from its members.
The program would establish a unified value-based incentive program to evaluate providers across a standardized set of measures, including:
- Risk-adjusted, claims-based measures such as Medicare spending per beneficiary
- Uniform performance targets that account for social-risk factors
The value-based incentive encourages increased focus on quality measures, the patient experience, and social-risk factors that might impact performance payments. Recommendations are expected to be finalized next year.
