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Advising the Congress on Medicare issues
MedPAC > Our Work > Beneficiaries and Coverage > June 2024 Report to the Congress: Medicare and the Health Care Delivery System

June 2024 Report to the Congress: Medicare and the Health Care Delivery System

Jun 13, 2024 / Reports

Executive Summary

As part of its mandate from the Congress, each June the Commission reports on improvements to Medicare payment systems and issues affecting the Medicare program, including changes to health care delivery and the market for health care services. The six chapters of the June 2024 report cover the following topics: 

Approaches for updating clinician payments and incentivizing participation in alternative payment models. The Commission considers two approaches for updating fee-for-service (FFS) Medicare’s physician fee schedule (PFS) payment rates and contemplates temporarily extending the bonus for participation in advanced alternative payment models (A–APMs).

• Provider networks and prior authorization in Medicare Advantage. The Commission discusses the use of provider networks and prior authorization in Medicare Advantage (MA) plans, CMS’s regulation of these tools, and the data that MA plans currently report in these areas.

• Assessing data sources for measuring health care utilization by Medicare Advantage enrollees: Encounter data and other sources. Using data from 2020 and 2021, the Commission assesses the relative completeness of MA encounter data and other data sources that contain information about MA enrollees’ use of services.

• Paying for software technologies in Medicare. The Commission reviews the Food and Drug
Administration’s (FDA’s) process for clearing software as a medical device (SaMD), examines
Medicare’s current coverage process and payments for medical device software under the payment
systems for Part A and Part B services, and discusses issues that policymakers should keep
in mind when considering paying for medical software in FFS Medicare.

• Considering ways to lower Medicare payments for select conditions in inpatient rehabilitation facilities. The Commission considers alternative approaches to lower FFS Medicare’s payment
rates to inpatient rehabilitation facilities (IRFs) for beneficiaries with select conditions.

• Medicare’s Acute Hospital Care at Home. The Commission assesses the experience to date of hospitals and beneficiaries in the FFS Medicare Acute Hospital Care at Home (AHCAH) program and reviews considerations for Medicare policy.

Excel files of the data underlying the figures in the chapters of this publication are available for download. Excel files are provided only when the data are not otherwise shown or labeled in the chapter.