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 Measure Creates Site-Neutral Payments For Post-Acute Care Providers

​A draft bill circulating in Congress would radically alter the way post-acute care (PAC) is provided and paid for by reforming and rationalizing Medicare services to make the system site-neutral, based on patient needs instead of where care is provided, according to sources within the American Health Care Association (AHCA), a supporter of the effort. 

The legislation, titled The Patient-Centered Prospective Payment System Act, lays out a series of reforms intended to remove what backers say are costly and inefficient practices in the current prospective payment system. 

AHCA insiders see the measure as part of the solution to the way scarce Medicare dollars are allocated. 

“This will save overall health care dollars, ensuring quality, and enhancing client/doctor relationships as a bonus,” the contact says.

In addition to abolishing the three-day stay requirement prior to recieving PAC, the draft act calls for the secretary of the U.S. Department of Health and Human Services to create a system based not on site of care for PAC, but on the needs of the patient. To do this, the legislation calls for the secretary to develop a single patient-assessment tool to determine care needs and the implementation of payment categories under the Medicare system related to those needs.

Providers will offer the necessary services according to a care plan developed by each patient care coordinator and in accordance with a physician’s order. This would permit a patient to be treated at any PAC setting that is willing to accept the Patient-Centered Payment amount, which reflects the expected needs of the patient.

The act would leave the decisions of where to go for PAC to be decided between the patient and his/her doctor.

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