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Advising the Congress on Medicare issues
MedPAC > Recommendations

Commission Recommendations

MedPAC makes recommendations to the Congress and to the Secretary of Health and Human Services on issues affecting the administration of the Medicare program. With its recommendations, the Commission strives to improve the delivery of care, while ensuring financial stability and maximizing value for the program. After extensive analysis and evaluation, our recommendations are discussed and voted on by Commissioners in our public meetings. Recommendations are typically published in two main reports, released in March and June of each year.

Recommendations Topic(s) Date

Improving Medicare’s end-stage renal disease prospective payment system (2)

The Secretary should replace the current low-volume and rural payment adjustments in the end-stage renal disease prospective payment system with a single adjustment for dialysis facilities that are isolated and consistently have low volume, where low-volume criteria are empirically derived.

  • Ambulatory care settings
  • Regional issues

June 2020

The Medicare Advantage program: Status report (2)

The Secretary should: establish geographic areas for Medicare Advantage quality reporting that accurately reflect health care market areas, and calculate star ratings for each contract at the geographic level for public reporting and for the determination of quality bonuses.

  • Part C (Medicare Advantage)
  • Quality
  • Regional issues

March 2018

Mandated report: Geographic adjustment of payments for the work of physicians and other health professionals

Medicare payments for work under the fee schedule for physicians and other health professionals should be geographically adjusted. The adjustment should reflect geographic differences across labor markets for physicians and other health professionals. The Congress should allow the geographic practice cost index (GPCI) floor to expire per current law and, because of uncertainty in the… Read more »

  • Physicians and other health professionals
  • Regional issues

June 2013

Medicare Advantage payment areas and risk adjustment (A)

The Congress should establish payment areas for Medicare Advantage local plans that have the following characteristics: * Among counties in metropolitan statistical areas, payment areas should be collections of counties that are located in the same state and the same metropolitan statistical area. * Among counties outside metropolitan statistical areas, payment areas should be collections… Read more »

  • Part C (Medicare Advantage)
  • Regional issues

June 2005

Medicare Advantage payment areas and risk adjustment (B)

The Secretary should update health service areas before using them as payment areas in the Medicare Advantage program. In addition, the Secretary should make periodic updates to health service areas to reflect changes in health care market areas that occur over time.

  • Part C (Medicare Advantage)
  • Regional issues

June 2005

Hospital inpatient and outpatient services (3)

The Congress should extend hold-harmless payments under the outpatient prospective payment system for rural sole community hospitals and other rural hospitals with 100 or fewer beds through calendar year 2006.

  • Hospital
  • Regional issues

March 2005

Hospital inpatient and outpatient services (4)

The Congress should raise the inpatient base rate for hospitals in rural and other urban areas to the level of the rate for those in large urban areas, phased in over two years.

  • Hospital
  • Regional issues

February 2003

Home health services (1)

The Congress should extend for two years the 10 percent add-on payments for home health services provided in rural areas.

  • Post-acute care
  • Regional issues

March 2002

Assessing payment for outpatient hospital care in rural areas

In the short term, no outpatient payment adjustments for rural hospitals are needed in addition to the current hold-harmless provision. The Secretary should revisit outpatient payments to rural hospitals when better information on hospitals’ experience with the payment system is available.

  • Hospital
  • Regional issues

June 2001

Improving payment for inpatient hospital care in rural areas (A)

The Congress should require that rural referral centers’ wages exceed the average wage in their area to quality for geographic reclassification, but these facilities should retain their waiver from the proximity rule.

  • Hospital
  • Regional issues

June 2001