MedPAC Discusses Inclusion of Hospice in Post-Hospital “Transfer” Policy
NAHC seeks input from its members by March 3, 2015
February 25, 2015 12:37 PM
In recent months, the Medicare Payment Advisory Commission (MedPAC) has been examining concerns related to hospitals’ increased use of “observation status” in response to Recovery Audit Contractors (RAC) reviews of the appropriateness of use of short-term inpatient stays.
Through its discussions, MedPAC plans to develop recommendations to ease existing tensions between hospitals and the RACs relative to short-stay hospital admission policies. Since any policy recommendations in this area would likely result in increased Medicare spending, MedPAC is also looking at policies that would yield savings to offset the cost of the recommendations. One savings option that has been put forth is that of including hospice in the post-acute hospital transfer policy.
In May 2013, the Department of Health and Human Services’ Office of the Inspector General (OIG) issued a report, “Medicare Could Save Millions by Implementing a Hospital Transfer Payment Policy for Early Discharge to Hospice,” recommending inclusion of hospice in the post-hospital transfer policy.
Based on discussions of the issue at its January 2015 meeting, MedPAC has estimated that hospitals currently enjoy an 88 percent financial margin on patients that are discharged “early” to hospice. If a post-hospital transfer policy were applied to early discharges to hospice, MedPAC estimates that hospital financial margins on short-stay patients discharged to hospice would be approximately 31 percent.
The National Association for Home Care & Hospice (NAHC) has concerns that inclusion of hospice in the post-acute hospital transfer policy could have a negative impact on hospice patients and the Medicare program by creating an incentive for some hospitals to maintain patients on higher cost hospital care for a longer period of time and delay admission to hospice, thereby diminishing the overall benefit that the patient and family could reap from hospice care.
NAHC is seeking input from its hospice member organizations on this issue for potential inclusion in comments to MedPAC.
If you have comments about the potential impact that inclusion of hospice in Medicare’s post-acute transfer policy could have on hospices, their patients, or the Medicare program generally, please email them to Theresa Forster (firstname.lastname@example.org) by COB March 3, 2015.