During the September 5–6, 2019 Medicare Payment Advisory Commission (MedPAC) public meeting, the agenda included a presentation that focused on a value incentive program (VIP) for post-acute care (PAC) providers. During the presentation, MedPAC reviewed their intention to develop this PAC-VIP over the coming months, which will tie providers’ payments under a unified PAC prospective payment system (PPS) to their performance on uniform cross-setting metrics. MedPAC feels PAC-VIP is essential to incentivize provider improvement. Some of the proposed measures to be included:

• All-condition hospitalization within the PAC stay;
• Successful discharge to the community; and
• Medicare-spending per beneficiary (MSPB).

Performance will be scored using absolute, prospectively set targets, and a five percent withhold will fund the incentive payments, which is consistent with Medicare’s existing value-based programs. In addition, because there is variation in performance across settings, there will be an initial need to score within each setting.

Next steps include modeling the PAC-VIP based on the Commission’s feedback and presenting their results in the spring. MedPAC also seeks feedback on the design of the PAC-VIP, such as measure set, scoring methodology, and size of the withhold. Contact RCPA Director of Rehabilitation Services, Melissa Dehoff, with questions.