Due to the coronavirus pandemic, MedPAC’s March 2022 public meeting was held virtually via video conference on the GoToWebinar platform.
03/03/2022 . 11:30 am - 12:45 pm
Findings from MedPAC’s annual beneficiary and clinician focus groups
ISSUE: Understanding the experiences and perspectives of Medicare beneficiaries is central to MedPAC’s work. To supplement our data analyses, we conduct focus groups aimed at providing more qualitative descriptions of beneficiary and clinician experiences with the Medicare program.
KEY POINTS: We present findings from our most recent focus groups.
ACTION: Commissioners will discuss the findings.
03/03/2022 . 1:45 pm - 3:45 pm
Medicare payment policies to support safety-net providers
ISSUE: The Medicare program strives to ensure access to care for all beneficiaries. However, some beneficiaries, such as those with low incomes, may have more difficulty accessing care. At the same time, providers who treat high shares of low-income beneficiaries may disproportionately rely on public payers and face greater financial challenges.
KEY POINTS: An alternative framework could be used to better identify safety-net providers and evaluate whether additional safety-net funding is warranted.
ACTION: Commissioners will discuss the material and provide guidance on future work.
03/03/2022 . 3:45 pm - 5:00 pm
Opportunities to strengthen the geriatric workforce
ISSUE: Medicare has a growing need for clinicians who specialize in treating elderly patients.
KEY POINTS: To learn more about the geriatric workforce, MedPAC staff analyzed Medicare claims data, reviewed the literature, and conducted expert interviews.
ACTION: The Commission will discuss the findings and policy options.
03/04/2022 . 10:30 am - 12:00 pm
Integrating episode-based payment with population-based payment
ISSUE: CMS concurrently operates many alternative payment models (APMs), which could dilute the strength of models’ incentives. In the June 2021 report to the Congress, the Commission therefore recommended that CMS implement a more harmonized portfolio of fewer APMs that are designed to work together.
KEY POINTS: The Commission continues to explore ways to harmonize CMS’s portfolio of APMs, including approaches for integrating episode-based payment with population-based payment.
ACTION: Commissioners will provide feedback on proposed approaches.
03/04/2022 . 1:00 pm - 2:00 pm
Improving Medicare Advantage risk adjustment by limiting the influence of outlier predictions
ISSUE: CMS uses risk adjustment to account for beneficiary health care cost differences in Medicare payments to Medicare Advantage (MA) plans. Risk scores are generated using the CMS–HCC model, which uses claims data from fee-for-service (FFS) beneficiaries to predict medical costs. Each demographic and health component in the model has a coefficient that represents the expected medical costs associated with that component. In general, the CMS–HCC model succeeds at avoiding systemic underpayments and overpayments for most MA enrollees. However, the data used to estimate the coefficients includes FFS beneficiaries who have annual Medicare costs that are very high or very low. Including these outlier beneficiaries in the risk model estimation introduces bias in the coefficients and generates payment inaccuracy in MA.
KEY POINTS: The literature has argued that a system of reinsurance and repayment could be used to address substantial overpayments and underpayments in the MA program at the enrollee level. However, MA cost data are insufficient to support a system of reinsurance and repayments. Last fall, the Commission began to explore a revised methodological approach that could improve the accuracy of the risk adjustment model by limiting the influence of cost data for FFS beneficiaries with large prediction errors.
ACTION: Commissioners will continue to discuss the revised approach.