The Medicare Payment Advisory Commission has suggested hospitals and doctors get payment bumps in 2018. Other sectors, including ambulatory surgery centers, skilled-nursing facilities and inpatient rehabilitation facilities, should get no increases, the group says.
MedPAC commissioners signed off Thursday on preliminary recommendations that the government boost Medicare payments for hospital inpatient and outpatient services in 2018 as outlined under current law, which is an estimated at 1.85%, and for physicians, which is at at 0.5%. Acute-care hospitals and physicians both saw slight increases in their Medicare volumes in 2015.
However, MedPAC repeated its suggestion from last year not to raise payments for ambulatory surgery centers in 2018, arguing those outpatient facilities appear to be financially healthy at current reimbursement rates, which hit $4.1 billion for 3.4 million Medicare beneficiaries in 2015. The industry unsurprisingly shot back.
“ASCs, just like other providers, need to be able to continue to cover the increasing costs they incur,” said Steve Miller, chief operating officer for the Ambulatory Surgery Center Association, a lobbying group. “Medicare needs to keep ASC payments competitive to ensure that its beneficiaries have continuing access to the high-quality, cost-effective care that ASCs provide.”
MedPAC similarly thought skilled-nursing facilities, hospices and long-term-care hospitals don't need higher rates. The group suggested modest cuts for home-health agencies and inpatient rehabilitation facilities since both groups of providers have profit margins ranging from 18% to 41.5%. For inpatient rehabilitation facilities specifically, MedPAC believes Medicare payments substantially exceed the costs of care.
A formal vote on the proposals will take place in January. If MedPAC secures majority votes from its commissioners, the recommendations will be sent to Congress and HHS in March as part of its annual report.