Next week, MedPAC kicks off the 2026-2027 meeting cycle when we convene our September public meeting. We would like to highlight that for each meeting this cycle we plan to offer in-person attendance and in-person comment opportunities at our public meetings. We are excited to share some of the policy issues MedPAC will be working on during this upcoming meeting cycle. The agenda may change based on data availability, analytic progress, the Commission’s discussions, and changing circumstances.
This cycle, the Commission will analyze recent trends in Part D spending, including the effects of the Part D benefit redesign that took effect in 2025. The redesign reduced cost sharing for beneficiaries and improved plan incentives to manage costs, but it has likely also contributed to increases in program spending. In 2027 and 2030, Medicare’s policies to slow the growth in beneficiary premiums will expire, making it increasingly important to address program costs to improve long-term sustainability for beneficiaries and taxpayers. The Commission will examine the implications of these trends for Medicare beneficiaries and the program and explore potential policy options to improve the program’s stability and affordability. The Commission will also assess recent trends in access to pharmacies and incorporate findings from focus groups with pharmacists.
We will also continue work examining the processes and information involved in beneficiary enrollment in Medicare. Last year, the Commission began analyzing the enrollment decisions that beneficiaries face, the complexity of the Medicare enrollment process, and the information sources that beneficiaries use to navigate those decisions. Building on that work, the Commission will continue to examine opportunities to simplify the enrollment experience and better support beneficiaries as they enroll in Medicare.
The Commission also plans to assess whether Medicare’s quality measurement and value-based payment programs are improving quality and providing value for the Medicare program, with a particular focus on clinician quality measurement programs. We will also continue analyzing the accuracy of Medicare payments to skilled nursing facilities and home health agencies, trends in Part B drug utilization and spending, hospice use patterns and Medicare spending effects, and Medicare’s payments for software as a medical service and prescription digital therapeutics. In addition, the Commission will present analyses of cost-sharing liability for services furnished by rural health clinics and examine the effects of converting to a rural emergency hospital on provider financial performance and beneficiary access to care.
As we do each year during the December and January public meetings, the Commission will analyze the adequacy of Medicare’s fee-for-service (FFS) payments and recommend appropriate updates for hospitals (including rural emergency hospitals), clinicians, outpatient dialysis facilities, skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and hospice agencies. The Commission also will deliver updated status reports on the Medicare Advantage (MA) and Part D programs, and on ambulatory surgical centers. These analyses will include information on Medicare payments, beneficiary access to care, and—where possible—the quality of care provided to beneficiaries. We also plan to report the average generosity of medical benefits in MA relative to FFS and compare MA enrollees’ out-of-pocket spending on premiums and health care services to what their spending would have been in FFS.
Beyond the annual status report, the Commission will also continue its work on the MA program. The MA program has grown significantly over the past decade, and it is increasingly important to understand enrollees’ experience in the program, additional benefits provided under MA, and its effect on Medicare finances. We will continue examining MA plan provider networks and access to care, requirements for institutional special needs plans (I-SNPs), and risk adjustment, including the role of encounter data. We plan to analyze how MA enrollees use different types and amounts of post-acute care services, including those provided by home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care facilities. We also plan to examine how MA plans pay providers for care.
MedPAC takes several steps to promote transparency in our work. In addition to offering in-person attendance and in-person public comment at each public meeting, we webcast the Commission’s public meetings and publish the transcript and presentations following each meeting. We also publish all reports, congressional testimony, and letters submitted by interested parties in response to public meeting discussions online. Throughout this cycle, we will continue to explore opportunities to make our work more accessible, including through shorter and alternative formats.
The Commission is required by statute to deliver two reports to the Congress each year: one by March 15th and another by June 15th. Our March report analyzes the adequacy of Medicare’s payments and makes recommendations to the Congress on whether and how those payments should be updated. Our June report focuses on broader questions affecting the Medicare program and may include recommendations to the Congress for improving Medicare’s payment systems to promote beneficiary access to care and efficient use of program resources. MedPAC publishes periodic data books with information about the Medicare program, its beneficiaries, and participating providers and plans; it also writes comment letters responding to proposed rules from the Centers for Medicare & Medicaid Services. Additionally, MedPAC produces its yearly Payment Basics series that explains how different Medicare payment systems work.
Our analytic agenda reflects MedPAC’s statutory requirements, congressional interest, and the priorities of the Commission, at the direction of MedPAC’s Chair and Executive Director. 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, evidence-based information and advice on Medicare.
We look forward to an exciting year ahead and hope that you will tune in to our public meetings. Please reach out to us at info@medpac.gov if you have any questions about MedPAC’s work.
