MedPAC’s December 2025 public meeting will be available via live webcast.
There are four separate sessions as indicated below. Given the limited number of registrants for each session, we request that you only sign up for the sessions you are able to attend.
Register for the Thursday, December 4 morning session (11:15AM to 12:45PM) by clicking here
Topics covered: Assessing payment adequacy and updating payments: Physician and
other health professional services
Register for the Thursday, December 4 afternoon session (1:30PM to 6:20PM) by clicking here
Topics covered: Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; mandated report on rural emergency hospitals; and update on site-neutral payments; Post-acute care: Trends and key issues; Assessing payment adequacy and updating payments: Skilled nursing facility services; Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services
Register for the Friday, December 5 morning session (10:00AM to 12:05PM) by clicking here
Topics covered: Assessing payment adequacy and updating payments: Home health
care services; Assessing payment adequacy and updating payments: Hospice services
Register for the Friday, December 5 afternoon session (12:45PM to 6:30PM) by clicking here
Topics covered: Assessing payment adequacy and updating payments: Outpatient
dialysis services; Improving Medicare’s payment approaches; Mandated report: The impact of recent changes to the home health prospective payment system; Mandated report: Assessment of the Medicare ground ambulance data collection system
Agenda
12/04/2025 . 11:15 am - 12:45 pm
Assessing payment adequacy and updating payments: Physician and other health professional services
Staff Contacts:
ISSUE: By law, each year the Commission reviews Medicare’s fee-for-service payment policies and makes payment update recommendations. For our March 2026 report to the Congress, we consider whether payments to physicians and other health professionals are adequate and how they should be updated in 2027.
KEY POINTS: We assess beneficiaries’ access to clinician care, quality of care, and the relationship between Medicare’s payments and clinicians’ costs.
ACTION: Commissioners will review and discuss the findings.
12/04/2025 . 1:30 pm - 2:55 pm
Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; mandated report on rural emergency hospitals; and update on site-neutral payments
Staff Contacts:
ISSUE: By law, each year the Commission reviews Medicare’s fee-for-service payment policies and makes payment update recommendations. For our March 2026 report to the Congress, we consider whether Medicare inpatient and outpatient payments to general acute care hospitals are adequate and how they should be updated in 2027. Beginning in March 2024, we also report annually on payments to rural emergency hospitals (REHs).
KEY POINTS: We examine beneficiaries’ access to hospital care, quality of care, hospitals’ access to capital, and the relationship between Medicare’s payments and hospitals’ costs. We also discuss REHs and site-neutral payments.
ACTION: Commissioners will review and discuss the findings.
12/04/2025 . 3:00 pm - 4:00 pm
Post-acute care: Trends and key issues
Staff Contacts:
ISSUE: Beneficiaries who require recuperative or rehabilitative care may be treated in skilled nursing facilities (SNFs) or inpatient rehabilitation facilities (IRFs) or by home health agencies (HHAs). While all three settings provide rehabilitation, skilled nursing, and personal care, the level of care varies, and the three settings differ in terms of Medicare benefits and cost sharing requirements under FFS Medicare.
KEY POINTS: Researchers have found some overlap in the types of patients treated in the three settings; however, data limitations undermine comparisons of outcomes and quality within and across settings. Medicare FFS margins for SNFs, HHAs and IRFs are high. Efforts to improve FFS payment for post-acute care have been on-going. Alternative payment models may show promise, while the shift in enrollment away from FFS Medicare to Medicare Advantage has important implications for providers and beneficiaries.
ACTION: Commissioners will review the material and discuss potential future work.
12/04/2025 . 4:15 pm - 5:15 pm
Assessing payment adequacy and updating payments: Skilled nursing facility services
Staff Contacts:
ISSUE: By law, each year the Commission reviews Medicare’s fee-for-service payment policies and makes payment update recommendations. For our March 2026 report to the Congress, we consider whether Medicare payments to skilled nursing facilities (SNFs) are adequate and how they should be updated in 2027.
KEY POINTS: We examine beneficiaries’ access to SNF care, quality of care, SNFs’ access to capital, and the relationship between Medicare’s payments and SNFs’ costs.
ACTION: Commissioners will review and discuss the findings.
12/04/2025 . 5:20 pm - 6:20 pm
Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services
Staff Contacts:
ISSUE: By law, each year the Commission reviews Medicare’s fee-for-service payment policies and makes payment update recommendations. For our March 2026 report to the Congress, we consider whether payments to inpatient rehabilitation facilities (IRFs) are adequate and how they should be updated in 2027.
KEY POINTS: We examine beneficiaries’ access to IRF care, quality of care, IRFs’ access to capital, and the relationship between Medicare’s payments and IRFs’ costs.
ACTION: Commissioners will review and discuss the findings.
12/05/2025 . 10:00 am - 11:00 am
Assessing payment adequacy and updating payments: Home health care services
Staff Contacts:
ISSUE: By law, each year the Commission reviews Medicare’s fee-for-service payment policies and makes payment update recommendations. For our March 2026 report to the Congress, we consider whether Medicare payments for home health care services are adequate and how they should be updated in 2027.
KEY POINTS: We examine beneficiaries’ access to home health care, quality of care, HHAs’ access to capital, and the relationship between Medicare’s payments and HHAs’ costs.
ACTION: Commissioners will review and discuss the findings.
12/05/2025 . 11:05 am - 12:05 pm
Assessing payment adequacy and updating payments: Hospice services
Staff Contacts:
ISSUE: By law, each year the Commission reviews Medicare’s fee-for-service payment policies and makes payment update recommendations. For our March 2026 report to the Congress, we consider whether Medicare payments for hospice services are adequate and how they should be updated in 2027.
KEY POINTS: We examine beneficiaries’ access to hospice services, quality of care, providers’ access to capital, and the relationship between Medicare’s payments and providers’ costs.
ACTION: Commissioners will review and discuss the findings.
12/05/2025 . 12:45 pm - 1:45 pm
Assessing payment adequacy and updating payments: Outpatient dialysis services
Staff Contacts:
ISSUE: By law, each year the Commission reviews Medicare’s fee-for-service payment policies and makes payment update recommendations. For our March 2026 report to the Congress, we consider whether Medicare payments for outpatient dialysis services are adequate and how they should be updated in 2027.
KEY POINTS: We examine beneficiaries’ access to outpatient dialysis services, quality of care, facilities’ access to capital, and the relationship between Medicare’s payments and facilities’ costs.
ACTION: Commissioners will review and discuss the findings.
12/05/2025 . 1:50 pm - 3:15 pm
Improving Medicare’s payment approaches
Staff Contacts:
ISSUE: Medicare spending is projected to nearly double over the next decade, driven by expected growth in the number of beneficiaries and in the volume and intensity of services delivered per beneficiary.
KEY POINTS: Since payment policy can have an impact on volume and intensity growth, it is important to consider the advantages and disadvantages of Medicare’s different payment methods—fee-for-service, alternative payment models such as accountable care organizations, and Medicare Advantage—and improvements that should be made to each.
ACTION: Commissioners will review and discuss the material.
12/05/2025 . 3:30 pm - 4:55 pm
Mandated report: The impact of recent changes to the home health prospective payment system
Staff Contacts:
ISSUE: In 2020, CMS implemented major changes to FFS Medicare’s home health prospective payment system (PPS), as required by the Bipartisan Budget Act (BBA) of 2018. These included a new 30-day period as the unit of payment (replacing the 60-day unit) and a new patient classification system (the Patient-Driven Groupings Model (PDGM)), which eliminated the number of therapy visits as a factor in the payment system.
KEY POINTS: The BBA of 2018 requires MedPAC to assess the impact of the changes to the home health PPS on agency payments and costs and the delivery and quality of care, and to provide an interim and a final report to the Congress. In March 2022, the Commission submitted its interim report assessing the initial impact of the PDGM on home health care in 2020. While disruptions related to COVID-19 complicated the analysis, we found that the PDGM itself did not substantially disrupt access to home health care. The Commission’s final report is due on March 15, 2026.
ACTION: Commissioners will review and discuss the findings.
12/05/2025 . 5:00 pm - 6:30 pm
Mandated report: Assessment of the Medicare ground ambulance data collection system
Staff Contacts:
ISSUE: CMS did not have cost data when the ambulance fee schedule was developed. Without cost data, it is not possible to know if Medicare’s payments to ambulance organizations are adequate to ensure beneficiary access to care. Further, it cannot be determined if payments under the AFS appropriately vary with the costs of transporting beneficiaries with different needs in different locations. To support analysis of whether the AFS payments are appropriate, the Congress directed CMS—via the BBA of 2018—to implement the Ground Ambulance Data Collection System (GADCS). CMS collected data for 2022 and 2023 from a sample of ambulance organizations, including information on organization characteristics, service area, service volume, response times, staffing and service mix, and certain categories of costs and revenues.
KEY POINTS:The BBA of 2018 requires MedPAC to report on the information submitted under the GADCS, including the burden on ambulance organizations of collecting the data and the utility of the data for ambulance payment. The report is due on June 15, 2026.
ACTION: Commissioners will review and discuss the findings.