Literature Review

Winter snow storm slams into over a dozen states in the East, Midwest USA Today; by Julia Gomez; 1/6/25 The Central Plains and Midwest are getting slammed by a winter storm , according to officials, and it's leaving over a dozen inches of snow in some places. Here's a look at what the storm is leaving behind. Over 60 million people in the Central Plains, Midwest and along the East Coast are being bombarded by heavy snowfall because of the "disruptive" winter storm moving through the area, according to the National Weather Service. Some areas could see snowfall anywhere between 8 to 14 inches. The storm is also expected to impact travel in Kansas City, St. Louis, Indianapolis and Cincinnati and bring the cities to a standstill.Editor's note: Are you ready for emergencies in your service areas? Click here for the CMS.gov Emergency Preparedness Rule. Click here for Wisconsin's CMS Emergency Preparedness Rule Toolkit: Hospices.

Hospice utilization rebounds to pre-pandemic levels, but fraud casts a shadow Hospice News; by Jim Parker; 12/17/24 The nation’s hospice utilization rate among Medicare decedents has once again surpassed 50%, for the first time since the pandemic. However, fraud issues in the space create questions around the quality of care patients are receiving. Hospice utilization reached 51.7% in 2023, up more than two percentage points from the prior year, according to recent data from the Medicare Payment Advisory Commission (MedPAC). This is the highest rate since 2019. MedPAC observed increases in utilization across the board, even when stratified into subgroups by age, sex, race and rural or urban location. ... Despite these positive trends, an influx of new hospices continued in states considered hotbeds for Medicare fraud, including Arizona, California, Nevada and Texas. Many of these new additions came in areas where additional hospices were likely not necessary based on the needs of the patient population. Georgia also saw a large spate of new providers emerge in 2023.

New from MedPAC: 2024 Payment Basics series - HospiceMedPAC press release; 10/25/24MedPAC announces the release of the updated 2024 Medicare Payment Basics series. MedPAC's mission is to advise the Congress on Medicare issues, and part of that mission is providing clear and accessible information about how Medicare works. Payment Basics is a series of explainers on how Medicare's payment systems function. These "basics" are typically no more than 5 pages long and feature handy diagrams that visually depict how the payment systems calculate providers' payments. MedPAC produces "basics" for the major payment systems (20 in all), and updates the series once a year in the fall. The updated versions are now available here.Publisher's note: Hospice Payment Basics linked in the title above.

MedPAC releases June 2024 report on Medicare and the health care delivery systemMedPac - Medicare Payment Advisory Commision; Press Release; 6/13/24The Medicare Payment Advisory Commission (MedPAC) released its June 2024 Report [on June 13, 2024] to the Congress: Medicare and the Health Care Delivery System. Each June, as part of its mandate from the Congress, MedPAC reports on improvements to Medicare payment systems, issues affecting the Medicare program, and changes to health care delivery and the market for health care services. This year’s report covers the following topics:

January 2024 MedPAC and MACPAC Data Book: Beneficiaries Dually Eligible for Medicare and MedicaidMedPAC; 1/22/24View and download the Data Book

MedPAC approves hospital, physician pay bump; Doubles down on post-acute cutsInsideHealth Policy, by Bridget Early; 1/12/24Congress’ Medicare pay advisors recommended pay raises in 2025 for hospitals and physicians along with extra so-called Medicare safety-net pay and voted Thursday ... to recommend a second year’s worth of post-acute pay cuts as it approved proposals that would lower base pay rates for skilled nursing facilities, home health agencies and inpatient rehabilitation facilities. 

Medicare Advantage market got more competitive in 2022—AMA.Modern HealthcareDecember 12, 2023The majority of the nation’s health insurance markets remain highly concentrated, but one segment of the industry in particular continues to grow more competitive—Medicare Advantage. The Medicare Advantage market has decreased in concentration since 2017 and continued to do so in 2022, according to the American Medical Association’s annual report Tuesday on health insurers. 

MedPAC draws fire with draft recommendations for massive home health cut, hospice rate freezeMcKnight’s Home Care DailyDecember 12, 2023The Medicare Payment Advisory Commission offered initial recommendations for Congress to cut home health reimbursement by 7% and pause hospice payment updates in 2025. “The 2022 [home health] margins remain above 20%, higher than the long-run average of 16.8% since 2001,” Evan Christman, senior analyst at MedPAC, said during last Friday’s public meeting, according to a transcript. “Overall, these margins indicate that Medicare fee-for-service continues to pay well in excess of cost.” Part of the reason home health agencies reportedly saw margins of 22.2%, on average, according to Christman, is a decline in the number of visits per 30-day period. Since the implementation of the Patient-Driven Groupings Model in 2020, these visits have declined more than 15%; between 2021 and 2022, visits per 30 days declined 3.5%. Home health advocates were quick to dispute MedPAC’s claims. “There are many shortfalls in MedPAC’s home health margins report—starting with the fact that MedPAC’s analysis only captures a declining fraction of the Medicare home health population, ignoring that overall margins are low,” Joanne Cunningham, chief executive officer of the Partnership for Quality Home Healthcare, said in a statement. ... The Partnership and National Association for Home Care & Hospice cited poor methodology and data in the recent home health final rule, which contained a Medicare cut related to PDGM. MedPAC also recommended that Congress eliminate any payment updates for hospice providers in 2025. 

MedPAC Meeting 12/7-8/23.Register for the Thursday, December 7 afternoon session (1:30PM to 5:00PM) by clicking here. Topics covered include: Assessing payment adequacy and updating payments: Hospice services.Notable Mentions: Kim Neuman.