Today, MedPAC releases its March 2015 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s analyses of payment adequacy in fee-for-service (FFS) Medicare and provides a review of Medicare Advantage (MA) and the prescription drug benefit, Part D.
News
Comment Letter on Quality Measurement in Medicare
Today MedPAC posted a comment letter to CMS on the list of Medicare quality measures under consideration for use in Medicare’s quality reporting or value-based purchasing programs. This year’s “list of measures under consideration” is a 329-page document listing hundreds of quality and resource use measures. Under the statute, CMS may consider including any of these measures during upcoming rule-making for its quality program. The list does not include the dozens of measures already adopted for Medicare’s quality programs, only potential new measures.
New report: Need for skilled nursing facility payment reform is urgent
The Commission released a report today finding that Medicare’s payments to skilled nursing facilities (SNFs) for therapy and nontherapy ancillary services are the least accurate they have been since 2006, despite Medicare’s numerous revisions to the payment system during this period.
New Report on Medicare Home Health Payment Rebasing
Today, the Commission released a report to the Congress assessing the impact of Medicare’s home healthcare payment rebasing on beneficiary access and quality. The report was mandated by the Patient Protection and Affordable Care Act, which also created the rebasing policy. The report’s primary finding is that rebasing – in other words, reducing the base payment rate for home healthcare – will not threaten beneficiary access to home health services or compromise quality of care.
Hospital Costs: What to Make of Them
Each year during its update process (read this post for more on that), the Commission examines Medicare’s payments to hospitals for inpatient and outpatient care. As part of this analysis, MedPAC compares Medicare’s payments to hospitals’ costs to determine a Medicare “margin.” For several years, these margins have been negative, indicating that on average, Medicare’s payments are less than hospitals’ costs. Some would argue that negative margins are an indication that Medicare needs to increase its payments to cover hospital costs. A different way to think about the issue is to ask whether hospitals’ costs have to be as high as they are and whether hospitals have the ability to control costs. Said differently, we wondered, “Are hospital costs immutable?”
Upcoming: MedPAC’s Annual Payment Updates
At our November meeting, we had a session on beneficiary access to hospital services, which was the first part of MedPAC’s yearly work on payment updates. Here’s an explainer on why we do this work and what it entails…
Opioid use among Medicare Part D enrollees
At MedPAC’s October public meeting, the Commission discussed patterns of potentially inappropriate opioid use in Medicare’s prescription drug benefit, Part D. In 2011, 10 million beneficiaries, or about 32 percent of Part D enrollees filled at least one prescription for an opioid. The share of Part D enrollees who use opioids in varies considerably across states.
Getting the Payment Rates Right in Medicare’s Fee Schedule for Physicians, Nurses, and Allied Health Professionals
At MedPAC’s October public meeting, the Commission had a session that focused on how Medicare can get the payment rates right in its fee schedule for physicians, nurses, and allied health professionals.
Payment Basics: A Traveler’s Guide to Medicare’s Payment Systems
Medicare has more than 20 distinct systems for paying health care providers who serve Medicare beneficiaries. Even we’d admit that it’s a lot to keep up with. MedPAC’s Payment Basics series can help.
Explainer: Risk sharing mechanisms in Part D
At MedPAC’s public meeting last week, the Commission discussed how Medicare shares financial risk with Part D prescription drug plans.