Home Health Leader Voices Strong Support for Post-Acute Care Bundling Legislation

WASHINGTON – Representing the Partnership for Quality Home Healthcare, Steven Landers, MD, MPH, today testified before the House Energy and Commerce Health Subcommittee at a hearing, Medicare Post Acute Care Delivery and Options to Improve It, urging lawmakers to advance reforms to replace Medicare’s fragmented and confusing post-acute care (PAC) system with policies that encourage increased care coordination, secure patient choice and reduce healthcare spending.

“We believe patient-centered care coordination can be achieved via PAC bundling that provides consistent support and navigation assistance to discharged Medicare beneficiaries. It’s for this reason that the Partnership is pleased to add its support to the Bundling and Coordinating Post Acute Care Act,” Dr. Landers testified. “In contrast to the challenges that compromise post-acute care today, the BACPAC Act strengthens care coordination, improves patient outcomes, ensures patient choice and achieves significant savings.”

The Partnership supports the bipartisan Bundling and Coordinating Post-Acute Care (BACPAC) Act (HR 1458) introduced last month by Congressmen David McKinley (R-WV), Jerry McNerney (D-CA) and Tom Price (R-GA) and cosponsored by Congresswoman Anna Eshoo (D-CA) because it supports stronger coordinated care delivery for the nation’s rapidly growing Medicare patient population.

Specifically, Dr. Landers testified that the BACPAC model will:

• Break down the barriers that today impair quality and produce inefficiency;
• Foster patient-centered care coordination across today’s siloes and among multiple providers;
• Enable care to be delivered in clinically appropriate and cost effective settings; and
• Achieve significant savings while rewarding physicians and providers for delivering quality care.

Through a newly established Condition Related Group (CRG) system, the BACPAC Act would bring organization and efficiency to PAC services, much like the Diagnosis Related Groups (DRGs) used in the hospital setting. CRGs are clinical condition-specific site-neutral bundled payments that would foster greater care coordination, improved outcomes, reduced readmissions, and meaningful savings.

Dr. Landers warned that maintaining the status quo in post-acute care delivery will leave patients and their families to navigate Medicare’s bewildering and burdensome system, stating, “The unfortunate reality is that, today, it’s really no one’s job to deliver patient-centered care coordination. Today, incentives are not aligned to get all people moving in the same direction and, as a result, patients are not being empowered or assisted, and care is not being coordinated.”

The BACPAC proposal establishes PAC coordinators to create networks of PAC providers to deliver clinically appropriate care in cost-effective settings. PAC coordinators – who patients and families would select prior to discharge – and their networks would manage a patient’s care for up to 90 days, using site-neutral CRG bundled payments that are initiated on the day of the patient’s discharge from the hospital. BACPAC would also help reduce the rate of hospital readmissions by holding PAC coordinators accountable for the cost of hospital readmissions.

If the patient’s total cost of care is lower than the patient’s CRG bundled payment amount, both the coordinator and providers are financially rewarded. These incentives therefore encourage the delivery of the most clinically- and cost-effective care possible.

BACPAC is designed to reduce overall Medicare spending for PAC services by four percent over the next 10 years and has the potential to reduce Medicare costs by tens of billions of dollars. These savings are achieved through increased coordination and efficiency, ensuring patients receive the most appropriate care in the most cost-effective setting and preventing unplanned, high cost interventions including hospital readmission. By achieving these savings, BAPAC also protects patients from increased out-of-pocket costs and providers from future across-the-board payment cuts that put patient access at risk.

To view the BACPAC infographic, click here.