For the second consecutive yr, the Medicare Cost Advisory Fee (MedPAC) has issued a draft advice advising Congress to scale back Medicare funds to house well being companies by 7% starting in 2026.

At its December assembly, MedPAC mentioned the adequacy of Medicare funds in varied supplier settings and reviewed its draft suggestions to Congress concerning 2026 fee updates.

MedPAC employees evaluated a number of components to evaluate fee adequacy, together with beneficiaries' entry to care, high quality of care, entry to capital, and the connection between Medicare funds and prices. Particularly, the committee really helpful fee updates for hospitals and physicians that exceed the necessities of present regulation.

“MedPAC's current suggestions concerning Medicare house well being and hospice insurance policies are deceptive and deeply troubling,” stated Dr. Steve Landers, CEO of the Nationwide Alliance for Care at Dwelling, stated in an announcement to Dwelling Well being Care Information. “With respect to house care, the advice for drastic cuts relies on a flawed evaluation of company margins that doesn’t have in mind all payers and the true monetary well being of the house care system.”

In his report back to Congress on house well being suggestions, Committee Member Evan Christ famous that entry to house well being care companies stays robust. Nonetheless, he pointed to a gentle decline within the share of hospital sufferers discharged to house take care of compensation, from 20.1% in 2020 to 18.2% within the first ten months of 2023.

In 2023, there was a rise within the variety of sufferers discharged to the neighborhood, from 79.3% to 80.6%.

Greater than 12,000 U.S. house well being companies served greater than 2.7 million sufferers in 2023, in keeping with the report.

“Whereas the MedPAC suggestions are hardly ever, if ever, handed by Congress and can’t be handed with out congressional motion, the concept is so as to add a 7% reduce on prime of the practically 9% everlasting reduce to house well being care since 2023 is solely unsustainable,” says Mollie. Gurian, vp of coverage and authorities affairs at LeadingAge, instructed HHCN. “Future fee reductions and clawbacks are sure to be topic to the company's interpretations of its present authorized obligations. With no change in course by Congress and CMS, entry to care will proceed to say no – and we hope that MedPAC will proceed to replicate on the function of Medicare Benefit on suppliers' viability and margins and regulate their definition of entry.”

Moreover, MedPAC employees offered suggestions for different healthcare supplier settings, together with a 3% enhance for physicians and different skilled healthcare companies; sustaining the present 1.7% fee for outpatient dialysis companies; sustaining hospice funds; a 3% discount in funds for expert nursing facilities and a 7% discount in funds for rehabilitation facilities.

MedPAC plans to vote on these formal suggestions at its subsequent assembly on January 11 and 12. Suggestions authorised throughout this vote will probably be included within the March 2025 report back to Congress.