MedPAC Urged To Recognize Critical Medicare-Medicaid Funding Link In Making Recommendation To Congress On FY 2012 Skilled Nursing Facility (SNF)

The following is a statement by Alan G. Rosenbloom, President of the Alliance for Quality Nursing Home Care, commenting on the Medicare Payment Advisory Commission (MedPAC) recommendation that Congress provide no FY 2012 cost of living adjustment for skilled nursing care:

"As we have in the past, and will continue to insist today and in the future, the U.S. Congress must make its Medicare funding decisions based upon the complete set of funding variables and economic realities facing America's skilled nursing facilities (SNFs). MedPAC's recommendation fails to consider the significant and historic underfunding of SNF patient care by state Medicaid programs. This underfunding negatively affects all government-funded patients in SNFs. For that reason, the impact of Medicaid and Medicare policies must be viewed together.

"MedPAC acknowledges that overall operating margins are just 1.9%, and this is before the impact of expiring Medicaid FMAP enhancements provided to states by the federal government, and other significant cuts in government payments that are planned.

"Stable staffing and funding are the twin pillars upon which our ongoing ability to provide quality care rests. In addition to the fact the National Governors Association (NGA) and National Association of State Budget Officers (NASBO) have warned of continued state budgetary chaos and the possibility of more cuts to Medicaid-funded eldercare programs in the year ahead, SNF Medicare cuts of nearly $30 billion over ten years have contributed significantly to sector instability.

"As Congress begins prioritizing FY 2012 budget priorities, the Alliance intends to aggressively spotlight not only the perpetual nature of the cumulative funding pressures placed on facilities, staffing and patient care, but also offer policy proposals to help advance quality care in the most cost-efficient manner possible.

"In order to protect hard-won quality gains for local Medicare beneficiaries, preserve good local health jobs, and to provide badly needed stability to one of America's most important health sectors, we urge Congress to provide a cost of living adjustment that reflects funding reality, the growing needs of our patient population, and the enormity of the challenge faced daily by caregivers across the nation."

Source: Alliance for Quality Nursing Home Care

Effort To Reward Medicare Advantage Plans Draws Criticism - Kaiser Health News

By Julie Appleby

Lake Wobegon has come to Medicare – and a key advisory panel doesn't like it.

The panel, the Medicare Payment Advisory Commission (MedPac), in a Jan. 6 letter does not mention the fictional Lake Wobegon, where all the children are above average. But it hints that not every Medicare Advantage insurer deserves to be above average.

The letter, to Dr. Donald Berwick, who heads the agency overseeing Medicare, criticizes a move to extend quality bonus payments meant for top-performing health insurers to those with lower scores. In fact, the new bonus program will reward even those plans highlighted on Medicare's own website as being poor performers over three consecutive years, according to the letter signed by MedPac Chairman Glenn Hackbarth.

The effort by the Centers for Medicare and Medicaid Services (CMS) will likely result in "far greater program costs" than the reward system called for by Congress in the health law and reduces insurers' incentive to achieve high performance, the letter concludes.

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The Health Care Blog: Pop the Cost Bubble: Unallot Medicare

by Victor M. Sandler, MD

Here’s a dirty little secret: Cutting health care costs is not that difficult, nor will it harm patients. That’s because it only involves giving up unnecessary medical care—tests and treatments patients may want but really don’t need because they don’t benefit their health.

How is this supposed to happen? In Minnesota we call it “unallotment.” When the state had to reconcile a projected multibillion dollar budget deficit this year, and the Republican governor and Democratic lawmakers couldn’t agree on how to do it, the governor simply “unalloted” billions of dollars of planned expenditures.
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Kaiser Family Foundation: Setting Medicare Payment Policy: Is There a Role for an Independent Entity?

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One of the issues that has recently emerged in health reform discussions concerns how to bring about change in the Medicare program to improve efficiency and control health care cost growth. The Obama Administration and some Congressional leaders have proposed establishing a new independent entity that would be given authority to recommend changes in Medicare policy to be implemented by the Administration, subject to Congressional review. This concept represents a significant departure from current practices. This issue brief considers questions associated with the establishment of a new entity to set Medicare payment policy and the implications for beneficiaries, other stakeholders, and program spending. It also explains the way Medicare payments are set under current law, including the advisory role currently played by the Medicare Payment Advisory Commission (MedPAC), as well as various options under consideration to create an independent Medicare payment entity. Download Issue Brief

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