Draft language presented by the Medicare Payment Advisory Commission said that Congress should implement a so-called virtual-bundling system that would reduce payments to hospitals and inpatient physicians that use more resources for certain conditions.
Savings from the payment penalty could be used to finance additional payments to low-spending, fee-for-service Medicare providers that give high-quality care, according to the draft recommendation. Implementation of the virtual-bundling system would follow a two-year period of data collection in which the CMS would be required to confidentially report on provider resource use.
The aim is to reduce Medicare spending, but MedPAC staff couldnt quantify whether virtual bundling would result in savings, additional costs or budget neutrality under the Medicare program. It depends on how the program is designed, staff indicated.
Commissioner Bruce Stuart was concerned that the drafts intentions werent clear. Its saying (virtual bundling) could improve coordination of patient carebut it might not, he said. Congress should also require the CMS to create a voluntary pilot program that would explore issues related to bundled payments across a hospitalization, according to another draft recommendation issued by staff. -- by Jennifer Lubell
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