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In a unanimous vote on Thursday, the Medicare Fee Advisory Fee (MedPAC) really useful that the Medicare base cost price for house well being must be decreased by 7% for calendar yr 2024.
This advice is in keeping with earlier suggestions by the fee over time.
The implications of a 7% discount would imply, amongst different issues, a lower in authorities spending by $750 million to $2 billion over one yr, based on the fee’s members.
“For beneficiary and supplier implications, we count on that entry to care ought to stay ample and it mustn’t have an effect on the willingness of suppliers to serve beneficiaries,” Evan Christman, a senior analyst for MedPAC, mentioned through the fee’s public assembly Thursday. “However it might improve price strain for some suppliers.”
The fee — established by the Balanced Funds Act of 1997 — often meets as a part of its mission to tell Congress on Medicare spending and coverage.
Based on MedPAC information, Medicare spent $16.9 billion on house well being providers in 2021.
There have been over 11,400 businesses offering house well being providers to three.3 million beneficiaries.
Elsewhere in its report, MedPAC steered that entry to house well being care is ample, citing that 98% of beneficiaries reside in a zipper code with two or extra businesses in 2021.
“We noticed a complete quantity lower however a per capita quantity improve,” Christman mentioned. “Businesses had a constructive Medicare marginal revenue of 25.9% in 2021. For entry to capital, the massive, for-profit businesses proceed to have ample entry to capital and we count on this to proceed. The all-payer margins have been constructive in 2021 at 11.9%.”
MedPAC was not capable of measure the standard of care, Christman mentioned, because of the pandemic and public well being emergency-related insurance policies.
Margins for Medicare cost and residential well being prices have been 24.9% in 2021, with a median margin of about 28%.
Broadly, MedPAC has lengthy pushed again in opposition to excessive house well being margins, although the trade itself says the fee’s analyses are deeply flawed and unfairly inflated.
Due to that, MedPAC has a historical past of recommending house well being cuts. Residence well being suppliers vehemently disagree with these suggestions, noting inflation, recruitment woes, wanted investments and lesser payouts for providers from Medicare Benefit plans.
Aside from house well being suggestions, MedPAC additionally voted to approve suggestions to cut back the 2023 Medicare-based cost charges for expert nursing services by 3%, the hospice mixture cap by 20% and inpatient rehabilitation services price by 3%.
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