Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s October agenda were:

• the skilled nursing facility value-based payment system
• future research directions in hospice payments
• Medicare Advantage benchmark policy
• indirect medical education:  current Medicare policy, concerns, and principles for revising
• the evolution of Medicare’s advanced alternative payment models
• vertical integration and Medicare payment policy

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues and here for a transcript of the proceedings.…

Expanded telehealth is here to stay, members of the Medicare Payment Advisory Commission agreed at their September public meeting.

What they do not yet know is in what form.

Among the issues that need to be addressed in any post-COVID-19 expansion of Medicare-covered telehealth services are:

• Whether affording access to telehealth services would exacerbate the digital divide and leave some Medicare beneficiaries with less access to care than others.
• Whether audio-only coverage, temporarily permitted during the pandemic, should be continued.
• Whether greater use of telehealth might foster greater use of low-value services.
• Whether use of non-HIPAA-compliant video technology should continue to be permitted.

Learn more about MedPAC’s deliberations on telehealth in the Healthcare Dive article “MedPAC commissioners hint at telehealth policies that may stick post-COVID-19” and see the presentation that formed the basis for the discussion of this issue at MedPAC’s recent public meeting.…

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s September agenda were:

• the coronavirus pandemic and Medicare
• context for Medicare payment policy
• report on the skilled nursing facility value-based purchasing program
• report on the Protecting Access to Medicare Act of 2014’s changes to the Medicare clinical laboratory fee schedule
• congressional request on private equity and Medicare
• expansion of telehealth in Medicare
• Medicare coverage for vaccines

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.…

MedPAC has submitted its annual report to Congress.

The congressionally mandated report, titled Report to Congress: Medicare and the Health Care Delivery System, consists of seven chapters:

• Realizing the promise of value-based payment in Medicare: an agenda for change.
  Challenges in maintaining and increasing savings from accountable care organizations (ACOs).
  Replacing the Medicare Advantage quality bonus program.
  Mandated report: Impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees.
  Realigning incentives in Medicare Part D.
  Separately payable drugs in the hospital outpatient prospective payment system (OPPS).
  Improving Medicare’s end-state renal disease (ESRD) prospective payment system (PPS).

While MedPAC’s recommendations are not binding on Congress or the administration, they are highly respected and often find themselves worked into new law or regulations.

Go here to see MedPAC’s news release accompanying the report and here to find the report itself.…

MedPAC has recommended to Congress changes in Medicare payment rates in the coming year.

In its annual report to Congress, the Medicare Payment Advisory Commission recommended the following rate changes:

acute-care hospitals – a two percent rate increase and a suggestion that the difference between this two percent increase and the payment increase specified by law be used to increase the rewards hospitals may earn under Medicare’s hospital value incentive program.  As a result, the value incentive program would offer a possible 0.8 percent in bonus payments, and with the recommended elimination of the 0.5 percent penalty for which hospitals are at risk, hospitals could average net increases of 3.3 percent.

• ambulatory surgical centers – no rate increase and a requirement that such facilities report cost data
• physicians – rates updated as already provided for by law
• long-term acute-care hospitals – a two percent increase
• inpatient rehabilitation facilities – a five percent rate reduction
• skilled nursing facilities – no rate increase
• dialysis facilities – rates updated as already provided for by law
• hospice services – no rate increase and the aggregate hospice cap should be wage-adjusted and reduced 20 percent
• home health agencies – a seven percent rate reduction

While …