Medicare Payment for Post-Surgical Recovery Care Centers.

摘要

In the Balanced Budget Refinement Act of 1999, the Congress instructed the Medicare Payment Advisory Commission (MedPAC) to examine the efficacy and cost-effectiveness of post-surgical recovery care centers (PSRCCs), review data from state demonstration projects, and report its findings by December 1, 2000. Currently, Medicare does not pay for stays in PSRCCs and limits payment for ambulatory surgery to procedures that are expected to require less than a four-hour post-operative observation period. This report reviews the characteristics of PSRCCs, discusses the policy questions raised by Medicare beneficiaries stays in these facilities, and presents the Commissions conclusions and recommendation regarding payment for care delivered by PSRCCs. PSRCCs represent a distinct class of health care facilities that provide limited medical and nursing care to patients who require short-term observation after surgery in an ambulatory surgical center (ASC). More complex procedures can be performed in ASCs that have the capacity to provide longer periods of postoperative care than in those without it. Over the past two decades, these facilities have increased in number and in private-sector use as technological advances have allowed more types of surgeries to be safely performed in an ambulatory setting.