The Medicare Payment Advisory (MedPAC) has recently been examining concerns related to hospitals’ increased use of “observation status” in response to Recovery Audit Contractors (RAC) reviews of appropriateness of use of short-term inpatient stays. MedPAC plans to develop new recommendations to ease tensions between hospitals and RACs relative to short-stay hospital admission policies. MedPAC is also looking at policies that would yield savings to offset the cost of the recommendations. One option is to include hospice in the post-acute hospital transfer policy. MedPAC estimates that hospitals currently have an 88 percent financial margin on patients that are discharged “early” to hospice. If a post-hospital transfer policy were to be applied to early discharges to hospice, MedPAC estimates that hospital financial margins on short-stay patients discharged to hospital would be about 31 percent. NAHC has expressed concerns regarding the inclusion of hospice in the post-acute hospital transfer policy and believe it could have a negative impact on hospice patients and the Medicare program.
NAHC is seeking input from its hospice member organizations on this issue. 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 to NAHC by COB March 3, 2015.
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