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Ways and Means Chairman Plans Changes to Post-Hospital Pay Bill

By Kerry Young, CQ Roll Call

September 23, 2016 --House Ways and Means Chairman Kevin Brady plans to put forward within months major revisions to his proposal for revamping how Medicare pays for services provided to people recovering after strokes and serious illnesses and injuries.  

The Texas Republican told CQ HealthBeat in a Thursday evening interview that he is taking a close look at responses to his legislation (HR 3298), which seeks to move post-hospital care more toward value-based purchasing. Groups responded strongly to his call for feedback on the measure, which would set performance standards and scores to rank providers and then peg payments to them. Trade associations last week said they couldn't support the bill in its current version, citing concerns about its penalties and the timing of proposed changes.

Brady said he is developing a revised version of the measure. He's hoping to finish it this year. Still, this work could take until early next year, meaning that he would introduce a new bill in the 115th session of Congress.

"It all depends on when we can find common ground," Brady said of the timeline. "The feedback we are getting is really helping us shape this."

Brady said he's looking at complaints raised about proposed quality measurements, timing and penalties in his bill.

Brady sees his bill as part of the continuing efforts to change how Medicare spends its money. Congress over the years has placed demands on doctors and hospitals to better coordinate care of the senior citizens and people with disabilities enrolled in Medicare. Lawmakers now want to do the same for what's called post-acute care, which includes home health services and treatments provided in skilled nursing centers and rehabilitation facilities. This field represents about 10 percent of Medicare's annual budget. 

"These reforms are very important to saving Medicare for the long term because it is moving toward real incentives for quality in the post-acute setting, just as we have redesigned reimbursement for doctors and hospitals to reward quality as well," Brady said.

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