Conn. Representative Raises Concerns Over Medicare Hospital Payments
House Ways and Means Committee Chair Nancy Johnson (R-Conn.) at a House hearing on Wednesday expressed concerns about a CMS proposal to cut Medicare payments to long-term care hospitals by 11% beginning July 1, CQ HealthBeat reports. LTCHs provide extended care for beneficiaries with complex conditions and are required by law to have an average length of stay of at least 25 days.
Under the proposal, Medicare would pay LTCHs the same amount for treatment of beneficiaries who stay for short lengths of time as it pays for care at acute care hospitals.
According to CQ HealthBeat, CMS officials say many "short stay outliers" do not actually require the more expensive care given by LTCHs and could instead receive care in less costly acute care hospitals or skilled nursing facilities. CMS estimates the payment reductions could save about $440 million over the 12 months starting July 1.
At Wednesday's hearing, Johnson said she was "terribly worried" about the proposal and suggested LTCHs instead use admissions criteria to determine which beneficiaries could receive care in less costly facilities.
Herb Kuhn, director of the Center for Medicare Management at CMS, said that such a system might not be enough to reduce short stays at LTCHs and that payment changes also would be needed to ensure they treat only appropriate patients. Kuhn said 60% of short stay outliers stay fewer than 14 days.
However, Johnson said the CMS proposal would target one-sixth of the LTCH population with the shortest stays, and not just patients who stay fewer than 14 days (Reichard, CQ HealthBeat, 3/15).