We are excited to share some of the policy issues MedPAC will be working on during the 2023–2024 meeting cycle. MedPAC’s agenda is shaped by a combination of statutory requirements, congressional interest, and the interests of the Commission, at the direction of MedPAC’s Chair. Three core principles guide our work: (1) payments should be sufficient to support beneficiary access to high-quality health care in an appropriate clinical setting; (2) Medicare payments should reflect efficient care delivery, thereby ensuring that the program’s fiscal burden on beneficiaries and taxpayers is not greater than necessary; and (3) providers should have incentives to supply appropriate and equitable care in an efficient manner. In all our work, MedPAC follows a deliberative, analytic process to provide the Congress with thoughtful, empirically based information and advice on Medicare.
MedPAC strives for transparency by webcasting the Commission meetings; publishing the transcript and presentations following such meetings; and publishing online all of its reports, comment letters, and congressional testimony. Additionally, MedPAC publishes two annual data books. In this spirit of transparency, we want to share the topics we plan to work on in the coming months. The topics and the precise schedule remain fluid based on data availability and analytic progress, the Commission’s discussions, and changing circumstances.
MedPAC is required by statute to deliver two reports to the Congress each year: one by March 15th and another by June 15th. The March report analyzes the adequacy of Medicare’s payments and makes recommendations to the Congress on whether and how those payments should be updated. The June report focuses on broader questions affecting the Medicare program, and it too includes recommendations to the Congress for improving Medicare’s payment systems to promote beneficiary access to care and efficient use of program resources.
In addition to these reports mandated by statute, MedPAC will fulfill two other mandates this cycle. As required by the Bipartisan Budget Act of 2018, we will provide an assessment of the Medicare Advantage (MA) special needs plans that serve dually eligible beneficiaries. And, for the first time, MedPAC will publish a review of the new rural emergency hospital payment model, as mandated by the Consolidated Appropriations Act, 2021.
In the coming months, the Commission will analyze the adequacy of Medicare’s fee-for-service payments for hospitals, clinicians, outpatient dialysis facilities, skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and hospice agencies. MedPAC will deliver its usual status reports on the MA and Part D programs, and on ambulatory surgical centers, including information on Medicare payments, beneficiary access to care, and—where possible—the quality of care.
As discussed at our September public meeting, the Commission is engaged in much work on MA. The MA program has grown tremendously over the past decade, and in response to such growth, we will focus on matters relating to that program. We plan to discuss MA coding intensity, standardizing enrollee cost sharing and certain supplemental benefits, favorable selection in MA, and dual-eligible special needs plans, as well as MA plan quality. We also intend to update our work on MA encounter data and introduce an analysis comparing those data with what MA plans submit as part of their bids.
We are working on several other issues in the Medicare program as well, including methods of updating payment rates under the physician fee schedule, payments for certain types of cases in inpatient rehabilitation facilities, staffing at skilled nursing facilities, the Acute Care Hospital at Home program, generic drug prices in the Medicare Part D program, and Medicare coverage of and payment for software approved or cleared by the Food and Drug Administration. Further, we plan to conduct analyses related to telehealth, Medicare’s coverage of inpatient psychiatric services, Medicare’s payments for beneficiaries receiving hospice care, and Medicare’s support of providers in rural areas.
Though this work will evolve over the course of our cycle, we expect many of these topics will be featured in our March and June reports to the Congress. And as always, MedPAC will respond to proposed rules affecting Medicare and to congressional requests for information about the program.
We look forward to an exciting year ahead and hope that you will tune in to our public meetings.