MedPAC recommends 1.25 percent update for FY2019 and replacing MIPS

The Medicare Payment Advisory Commission (MedPAC) convened on Jan. 11 and voted to recommend that hospitals receive a 1.25 percent FY2019 update to be applied for Medicare inpatient and outpatient services. MedPAC stated that hospital Medicare margins continue to decline and are projected to be minus 11 percent in 2018. South Dakota’s Total Medicare Margin for 2015 was a negative 3.10 percent.

The commission also recommended that the Department of Health and Humans Services implement a redesigned skilled nursing facility (SNF) prospective payment system in 2019 and provide no payment update for SNFs in 2019 and 2020.

In addition, MedPAC recommended:

  • 5 percent cut for inpatient rehabilitation facilities in 2020.
  • No update for long-term care hospitals in 2020.
  • 5 percent cut for home health agencies in 2019 and a two-year rebasing of the home health payment system beginning in 2020.
  • Payment reduction for all four post-acute settings by blending existing relative weights with those from its new post-acute care PPS prototype.

With a 14-2 vote, the commission recommended to Congress to replace the Merit-based Incentive Payment System (MIPS) for clinicians and establish a new voluntary value program based on population-based measures. The recommendation will be published in the advisory group’s annual March report to Congress.