While no vote was taken, panel members appeared to unanimously support including the proposals in MedPAC's March 2014 report to Congress.
The key recommendation would cut hospital payment rates for a variety of services so they are comparable to physician offices.
For instance, this year Medicare pays about 140% more for an echocardiogram offered in a hospital outpatient department than it does for the same service in a freestanding physician's office. That not only costs Medicare more, it raises the beneficiary's copay, according to the congressional advisory panel. It also incentivizes hospitals to shift services to the more costly in-patient environment when they have the option of doing so.
The commission also recommended bringing payments to long-term acute care hospitals in line with those paid to acute care hospitals for patients who spend fewer than eight days in an intensive-care or critical-care unit. The proposal would reduce Medicare payments for long-term care hospitals by $2 billion in 2015.
While the commission voiced approval for the recommendations without dissent, some panel members expressed concern about recommending an abrupt change in long-term hospital payment policy. The changes are “quite significant and there needs to be a transition period,” said Dr. Craig Samitt, executive vice president of HealthCare Partners, the huge California-based physician practice owned by DaVita.