Medicare Offers Hospitals $1.9 Billion in 2021 Incentive Payments

Medicare would make about $1.9 billion available for value-based incentive payments to hospitals in fiscal year 2021 under a proposed payment rule released Monday.

In addition, Medicare payments to hospitals for uncompensated care would fall by $534 million in the 2021 fiscal year, according to the proposal by the Centers for Medicare & Medicaid Services. The proposed changes would update three factors that determine the payments.

And the nation’s 360 long-term care hospitals would see Medicare payments fall by roughly $36 million under the proposed Inpatient Prospective Payment System and the Long-Term Care Hospital Prospective Payment System rule for fiscal year 2021.

Medicare spent about $4.2 billion at long-term care hospitals in 2018, according to the Medicare Payment Advisory Commission. That amount encompassed just over 100,000 Medicare cases. The average Medicare payment per case was about $40,000, the commission reported.

The 1,600-page proposal also calls for a new Medicare hospital payment category for CAR-T cell therapy treatments, which use a patient’s genetically modified cells to treat certain types of cancer. The new inpatient payment category would help standardize payment rates for hospitals that provide CAR-T therapy, the CMS said.

The proposed rule also calls for removing barriers to the use of new antimicrobials, the antibiotics used to treat drug-resistant infections that disproportionately affect Medicare beneficiaries. The proposal would create an alternative pathway for hospitals to get an additional payment from Medicare if they use eligible high-cost technologies.