Filed Under:Health Insurance, Ltci

Republicans, Democrats join in Medicare post-acute care letter

Rep. Dave Camp, R-Mich. (AP photo/J. Scott Applewhite)
Rep. Dave Camp, R-Mich. (AP photo/J. Scott Applewhite)

Republicans are teaming up with Democrats in Congress to try to come up with ideas for improving Medicare's post-acute care benefits.

In the Medicare program, the term "post-acute care" covers what some in the private insurance industry call "short-term care." Medicare does not normally cover true long-term custodial care, but it does cover care in long-term care hospitals, skilled nursing facilities and inpatient rehabilitation facilities, and care provided by home health agencies.

The leaders of the House Ways and Means Committee and the Senate Finance Committee have put out a call for ideas about how to improve the quality of post-acute care, improve payment accuracy, fight fraud, and reduce variations in use of different types of services.

The group of leaders that sent out the request for ideas includes Ways and Means Chairman Dave Camp, R-Mich.; Rep. Sander Levin, D-Mich.; Senate Finance Chairman Max Baucus, D-Mont.; and Sen. Orrin Hatch, R-Utah.

In a letter addressed to "stakeholders," the congressional leaders note that Medicare spent $62 billion on post-acute care in 2011.

“Medicare post-acute care providers play a vital role, providing important services to beneficiaries recovering from a serious hospital stay," the lawmakers say in the letter. "We are troubled by the substantial variation in Medicare spending, utilization, quality, and margins within the post-acute sector."

The goal should be to ensure that Medicare beneficiaries receive the right post-acute care, in the right setting at the right time with the highest level of quality, the lawmakers say.

The lawmakers suggest that one weakness in the Medicare program is that Medicare rules do not clearly state which types of patients belong in which setting.

Because comparable facilities have different types of patiets, "the quality of care and patient outcomes often cannot be compared across settings, making it impossible to evaluate the comparative efficacy of services provided in different settings," the lawmakers said.

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