MedPAC discusses potential payment approaches to short hospital stays, quality

The Medicare Payment Advisory Commission today discussed two topics it expects to make draft recommendations on when it meets in March – hospital short-stay policy issues and next steps in measuring quality of care in Medicare. The hospital short-stay discussion focused on reducing payment differences between observation and inpatient stays of one and two-plus days; reducing the burden of Recovery Audit Contractor reviews and increasing RAC accountability; and protecting beneficiaries in relation to the three-day inpatient qualifying requirement for skilled nursing care and liability for self-administered drugs. The quality discussion focused on the commission's efforts to develop a population-based outcome measure to assess patients' “healthy days at home,” meaning the number of days without inpatient or certain post-acute care services, and considered which entities would be most appropriate to assess with the measure as well as risk adjustment issues.