MedPAC Discusses a PAC Value Incentive Program

September 11, 2019


The Medicare Payment Advisory Commission (MedPAC) held its September public meeting on Sept 5-6, 2019. At the meeting, MedPAC staff presented a proposal for a uniform post-acute care (PAC) value incentive program (VIP). This proposed program would apply to all PAC providers and tie a portion of a provider’s payments to quality and value, using a common set of population-based measures. Implementation of the PAC-VIP would require Congressional action. Presentation slides for the PAC-VIP presentation can be found here.

The proposed PAC-VIP, which builds on previous work done by the Commission, includes three measures:

  • hospitalizations during a PAC stay;
  • successful discharge to the community; and
  • Medicare spending per beneficiary (MSPB) from which providers will be scored.

While the PAC-VIP would be applied uniformly across PAC settings, providers would be grouped into peer groups, with the proportion of patients who are eligible for Medicaid as the peer grouping metric. Based on provider scores, pooled dollars from the proposed 5% withhold within a peer group would be redistributed within the same peer group.

The Commission provided MedPAC staff with feedback on the different measures, scoring methodology, and the size of the withhold. MedPAC staff is planning on incorporating Commissioner feedback and presenting an updated proposal at a public meeting in 2020.

The next MedPAC public meeting is scheduled for October 3-4, 2019. More information, previous reports, and information about past and future public meetings can be found on the MedPAC webpage.


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Kelsey Haag at 202-204-1464/ or Sheila Madhani at 202-204-1459/

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