MedPac Flags Home Health Referral Problem

By Robert Holly | June 18, 2018

The Medicare Payment Advisory Commission (MedPAC) has alerted Congress to how rarely home health patients pick their neighborhood’s highest quality provider after being discharged from the hospital.

MedPAC compiles its regular report to advise Congress on payments to health plans participating in the Medicare Advantage program and providers in Medicare’s traditional fee-for-service program, but lawmakers are not required to follow its recommendations. The commission issues its reports in March and June. The latest report, issued last Friday, addresses home health-related topics that MedPAC previously discussed during public meetings, including the issue of people choosing low-quality post-acute providers. It also tackles the issue of how a unified post-acute payment system might handle subsequent stays.

Medicare policy places a premium on protecting a patient’s ability to choose a post-acute care (PAC) provider, but does not encourage them to pick the best one. As a result, more than 94% of beneficiaries who use home health agency services after a discharge have at least one provider within a 15-mile radius with a higher quality score than the provider from which they receive services, a MedPAC review of referral patterns revealed. About 70% of beneficiaries have five or more home health agencies in their area known to provide better quality care.

The difference in quality of care is often not even close, according to MedPAC.

For complete article, click here.

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