The U.S. House Committee on Ways and Means has passed a bill that among other provisions, would provide relief to hospital outpatient departments as well as consider patients’ socioeconomic status before penalizing hospitals in the Hospital Readmissions Reduction Program.
Indeed, the bipartisan Helping Hospitals Improve Patient Care Act addresses payments to hospitals and other Medicare providers. Introduced by Health Subcommittee Chairman Pat Tiberi (R-Ohio) and Ranking Member Jim McDermott (D-Wash.), the legislation advances several bipartisan member priorities that will aim to help medical providers better treat patients in their communities.
Regarding hospital outpatient departments, a section of the Bipartisan Budget Act of 2015, lowered the rate at which Medicare reimbursed off-campus doctors' offices owned by hospitals. However, the law did not take into account facilities that were “mid-build” as of the date of the enactment. In accordance with how such situations are treated in other Medicare payment systems this legislation would allow providers that were already building new off-campus outpatient facilities to be grandfathered into the outpatient payment rates. This provision is offset by a slight reduction in the hospital inpatient documentation and coding adjustments as implemented in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.
What’s more, the bill provides a bridge to improved consideration of socioeconomic status in the Hospital Readmissions Reduction Program to prevent penalizing hospitals that serve low-income patients, without masking socioeconomic disparities. Until reports and data required under the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT) are available, the Secretary of Health and Human Services (HHS) would compare performance of hospitals that service similar proportions of dual-eligible individuals in applying adjustments under the readmissions program. But after the IMPACT studies are completed, the Secretary would be able to adjust the performance based on the IMPACT data and research, according to the bill.
The Charlotte, N.C.-based Premier Inc. supports the committee’s efforts to improve the readmissions program. In a statement released by Premier, Blair Childs, senior vice president of public affairs, said, “The Helping Hospitals Improve Patient Care Act. Our research and other studies have shown that socioeconomic factors, such as income and race, are directly linked to a patient’s likelihood for readmission. These are beyond a hospital’s control and failing to fully adjust for these factors will cause some hospitals to be unfairly penalized. Penalizing hospitals treating the most vulnerable populations for outcomes beyond their control must be addressed.”