Home Health Leaders Applaud Introduction of Bipartisan Bundling and Coordinating Post-Acute Care (BACPAC) Act

Washington, DC – Home health community leaders today praised the introduction of the bipartisan Bundling and Coordinating Post-Acute Care (BACPAC) Act (HR 1458) by Congressmen David McKinley (R-WV), Jerry McNerney (D-CA) and Tom Price (R-GA). The BACPAC Act is a comprehensive proposal that supports the coordinated delivery of clinically advanced care in cost-effective settings for the nation’s rapidly growing Medicare patient population.

Through the Condition Related Group (CRG) payment system it establishes, the BACPAC Act brings to post-acute care (PAC) services the organization and efficiency that hospitals have long experienced with Diagnosis Related Groups (DRGs). CRGs are clinical condition-specific site-neutral bundled payments that will foster greater care coordination, improved outcomes, reduced readmissions, and significant savings – all without provider cuts or increased out-of-pocket costs for Medicare beneficiaries.

“The Partnership is proud to commend Reps. McKinley, McNerney and Price on their introduction of this important legislation. BACPAC offers Congress a powerful opportunity to achieve significant savings through positive structural change rather than through higher beneficiary cost-sharing or further provider cuts,” stated Eric Berger, CEO of the Partnership for Quality Home Healthcare. “The BACPAC Act puts patient-centric solutions on the table that reward the delivery of coordinated, effective and efficient healthcare and benefit seniors, the Medicare program and taxpayers.”

The BACPAC proposal bundles payments for PAC services in a manner designed to strengthen care coordination, improve patient outcomes, ensure patient choice, and achieve significant savings. Under the BACPAC model, coordinators establish networks of PAC providers to deliver clinically appropriate care in cost-effective settings.

Under the BACPAC model, PAC coordinators and their networks of PAC providers 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. Importantly, BACPAC will also help reduce the rate of hospital readmissions by holding PAC coordinators accountable for the cost of hospital readmissions. Finally, BACPAC rewards participants if the total cost of a patient’s care is lower than the patient’s CRG bundled payment amount. Through these mechanisms, BACPAC will align incentives for the delivery of the most clinically- and cost-effective care possible.

As drafted, BACPAC will reduce overall Medicare spending for PAC services by four percent over the next 10 years – all without reducing any provider’s rates – and distributes 100 percent of savings achieved beyond that level to the coordinator, discharging hospital, managing physician, and PAC providers who serve each patient.

“BACPAC offers a positive approach to savings – in place of the old ‘stand-bys’ of provider rate cuts and beneficiary cost increases, BACPAC achieves savings through a proven mechanism that will prioritize quality outcomes and cost-effectiveness,” added Berger. “We look forward to working with Congressmen McKinley, McNerney and Price as they advance this thoughtful and forward-looking proposal.”