MedPAC Recommendations

What MedPAC is recommending be done to Medicare

MedPAC (Medicare Payment Advisory Commission) is an independent congressional agency that was established by the Balanced Budget Act of 1997. The agency is tasked with providing advice and recommendations to the US Congress on issues related to Medicare, the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD).

MedPAC is composed of 17 members who are appointed by the Comptroller General of the United States. The members are healthcare experts who have a diverse range of backgrounds, including healthcare providers, health policy experts, and consumer advocates.

MedPAC’s primary role is to advise Congress on issues related to Medicare payment policies and healthcare delivery system reforms. The agency’s recommendations are intended to help Congress make informed decisions about how to improve the Medicare program, reduce costs, and ensure access to high-quality healthcare services for beneficiaries.

Some of the issues that MedPAC focuses on include Medicare payment rates, the structure of the Medicare program, the quality of care provided to beneficiaries, and ways to reduce healthcare spending while maintaining or improving the quality of care.

MedPAC produces a number of reports each year that provide analysis and recommendations on these and other issues related to the Medicare program. These reports are an important source of information for policymakers, healthcare providers, and other stakeholders who are involved in the Medicare program.

In recent years, MedPAC has made several recommendations to improve Medicare’s payment and delivery systems. Some of these recommendations include:

  1. Implementing site-neutral payments: MedPAC has recommended that Medicare should pay the same amount for similar services provided in different settings, such as hospital outpatient departments and ambulatory surgical centers. This would help reduce Medicare spending and encourage patients to seek care in lower-cost settings.
  2. Reducing Medicare Advantage (MA) overpayments: MedPAC has recommended that Medicare should reduce the payments made to MA plans to bring them in line with traditional Medicare costs. This would help eliminate the overpayments that MA plans receive, which can increase Medicare spending.
  3. Encouraging the use of alternative payment models (APMs): MedPAC has recommended that Medicare should encourage the use of APMs, such as Accountable Care Organizations (ACOs), that incentivize providers to improve quality and reduce costs. APMs can help shift the focus of healthcare delivery from volume-based care to value-based care.

ACOs consistent with MedPAC’s recommendations

ACOs are consistent with MedPAC’s recommendation to encourage the use of APMs. ACOs are groups of healthcare providers who work together to coordinate care for a specific population of patients. ACOs are designed to improve the quality of care and reduce healthcare costs by incentivizing providers to work together to improve patient outcomes.

MedPAC has supported the use of ACOs as a way to improve care coordination and reduce costs in the Medicare program. In fact, MedPAC has recommended that Medicare expand the use of ACOs and other APMs to encourage providers to deliver high-quality, cost-effective care.