Skilled Nursing Facilities

Today I summarize recent trends in skilled nursing facilities (SNFs) as outlined in MedPAC’s 2011 Report to Congress. SNFs furnish short-term skilled nursing and rehabilitation services to beneficiaries after a stay in an acute care hospital. These services include physical and occupational therapy and speech–language pathology services. Examples of SNF patients include those recovering from…

MedPAC’s Home Health Recommendations

In their latest 2011, MedPAC made four recommendations to alter payment policy in the home health setting.  These include the following: The Secretary, with the Office of Inspector General, should conduct medical review activities in counties that have aberrant home health utilization.  The Secretary should implement the new authorities to suspend payment and the enrollment…

Medicare Payment Adequacy

How do policymakers  determine if Medicare payment levels are adequate?  The Medicare Payment Advisory Commission (MedPAC) uses the following criteria: Access to care determined by the number of providers and volume of services. Quality of care Provider access to capital Provider margins. Although these measures do provide valuable information, they are far from perfect.  Access…

Medicare Reimbursement Information III

Today, we will focus on hospital care outside of the traditional Inpatient hospital care setting. Again, this information is culled from MedPAC reports. Outpatient Hospital Services Outpatient hospital care, from injections to complex procedures, accounted for $19 billion of total Medicare spending in 2007 Originally, outpatient reimbursement was cost based and copayments amounted to about…