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Published by Bloomberg BNA
May 20, 2015

Development: Rep. David McKinley (R-W.Va.) supports site-neutral payment bill for post-acute care.

The lawmaker behind legislation that would bundle Medicare payments for post-acute care (PAC) services is calling on stakeholders to support the bill.

In a May 19 speech, Rep. David B. McKinley (R-W.Va.) told the Alliance for Home Health Quality and Innovation current policies are putting home health agencies in jeopardy. He said cuts to home health providers have threatened 40 percent of all home health agencies across the country, especially in rural areas. To prevent further cuts, McKinley said Medicare needs a more efficient payment system.

McKinley said his bill, the proposed Bundling and Coordinating Post-Acute Care (BACPAC) (H.R. 1458) Act, would save Medicare between $20 billion and $30 billion over 10 years without cutting payments to providers. The legislation would provide for a post-acute, risk-based, bundled payment that would be made, per beneficiary, to a post-acute care coordinator. This payment would include post-acute care services, except for physician services, outpatient therapies, outpatient ambulance, hospice and outpatient hospital services.

“We must look to common-sense savings to preserve Medicare services, protect jobs and make sure we keep our promise to seniors,” McKinley said.

Site-Neutral Payments

Under the BACPAC model, PAC coordinators and their networks of PAC providers manage a patient's care for up to 90 days, using site-neutral bundled payments that are initiated on the day of the patient's discharge from the hospital, according to a bill summary. The legislation also attempts to reduce the rate of hospital readmissions by holding PAC coordinators accountable for the cost of hospital readmissions. The bill would also reward participants if the total cost of a patient's care is lower than the patient's bundled payment amount.

President Barack Obama and the House already have put post-acute care bundling in their respective budget requests, McKinley said.

The legislation was introduced in March. The bipartisan bill has the support of many stakeholders, but the American Health Care Association—which represents nursing homes—objected to the bill during a hearing in April (74 DER A-19, 4/17/15).