MedPAC urges Congress to consolidate Medicare quality programs, increase payment rate

The Medicare Payment Advisory Commission (MedPAC) recently recommended Congress pass legislation to merge hospital quality initiatives into one program, the Hospital Value Incentive Program (HVIP), which would tie Medicare payments to the quality of hospitals’ care. MedPAC argued this consolidation would eliminate existing confusion and overlapping requirements.

  • The HVIP would take effect in 2020 and would increase acute care hospitals’ payment rate by 2 percent. The commission also suggested increasing payment rates for long-term care hospitals by 2 percent
  • The program would double quality program spending from $5 billion to $10 billion over the next five years
  • The HVIP would consolidate three programs on hospital readmissions, value-based purchasing and hospital-acquired conditions, and abolish the inpatient quality reporting program

MedPAC recommended rewarding hospitals using the same quality metrics: mortality, spending, patient experience, hospital-acquired conditions and readmissions, with each hospital receiving a score between 0 and 10 for each measure, and its total score based on the average of all five scores. MedPAC also indicated the HVIP would account for patients’ social risk factors, and would grant hospitals serving more dual-eligible Medicare and Medicaid patients a larger percentage increase in payments.

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