MedPAC Members Meet With Rural Providers To Discuss Perceived Payment Disparities
Three members of the Medicare Payment Advisory Commission are meeting with health care leaders in the Midwest this week to discuss changes in the Medicare payment system for rural providers, the Fargo Forum reports. According to the Forum, many rural health providers believe they were "shortchanged by the Medicare program" because it paid urban providers at a higher rate and did not reward rural providers for providing "effective, low-cost care" (Springer, Fargo Forum, 6/29). To address the perceived payment disparity, the new Medicare law includes $25 billion in extra payments to rural hospitals that provide care to Medicare beneficiaries (California Healthline, 11/26/03). In addition, CMS in May proposed increasing payments to rural hospitals by 6% (California Healthline, 5/12).
MedPAC is expected to release a report early next year evaluating the higher payments to rural Medicare providers. In addition, the commission is considering a system that would create incentives to reward medical providers for providing cost-efficient care, beginning with payments for some chronic conditions, such as kidney dialysis. Commission members are meeting with providers and insurers in Minneapolis, Fargo, N.D., and Billings, Mont., to discuss the changes, marking the first time the commission or its staff have met with providers outside of Washington, D.C., according to commission member David Durenberger. He said that the meetings in the Midwest are "a way to come out and talk to people that are actually running hospitals and nursing homes and health plans and whatever." Mary Wakefield, director of the Center for Rural Health at the University of North Dakota and a member of the commission, said MedPAC is trying to "tak[e] the temperature" of whether the new payment scheme is working.
MedPAC members also discussed a proposal to create a pay-for-performance system under Medicare (Fargo Forum, 6/29). Earlier this month, Sen. Max Baucus (D-Mont.) introduced a bill called the Medicare Quality Improvement Act that would establish a series of bonus payments for Medicare Advantage -- the program's managed care plans, formerly called Medicare+Choice -- and Medicare's End Stage Renal Disease providers, which serve kidney dialysis beneficiaries. The bonus payments would be available to "any participating provider, hospital or health plan that demonstrates improved quality of care through structural or capacity improvements such as translator services, telemedicine or cultural competence," according to the bill summary. The measure would also establish a "Quality Advisory Board" to advise the HHS secretary "on quality measurement, pay-for-performance, and the development of a national quality agenda," according to the bill summary. In addition, the legislation would seek input from HHS and the Institute of Medicine to create a "roadmap" for implementing a pay-for-performance system to all of Medicare (California Healthline, 6/24).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.