Members of the Medicare Payment Advisory Commission (MedPAC) endorsed staff recommendations that that commission’s March report to Congress include lower Medicare payments to agencies that exceed a set rehospitalization limit for patients they admit.
 
            The Jan. 16 vote came after MedPAC staffers offered additional details about the proposal, which initially was discussed by the commission at its December meeting. The penalties could affect agencies whose readmission rates exceeded rates for the 40% of agencies scoring lowest for readmissions, according to a staff analysis based on 2010 data.
 
            The proposal would have reduced payments to agencies by $90 million in 2010 and saved Medicare $300 million in avoidable hospitalizations. Agency efforts to improve their hospitalization rates could reduce the impact, however, the MedPAC staffer Evan Christman observed.
 
The fourth of agencies with 58% of the readmissions — compared with 26% for the remaining agencies — could be most affected by the penalties, Christman suggested. Texas, Louisiana, Oklahoma and Mississippi, which have above-average home health admission rates and lengths of stay, had hospital readmission rates of 38%, the staff noted in its December discussion of the proposal.
 
            MedPAC members also agreed to renew savings recommendations that the commission has called for, starting in 2011, including a home health copay and a moratorium on enrollment of new agencies in areas with “aberrant” utilization, such as Texas and Louisiana.