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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
Revising payment methods and monitoring quality of care in traditional Medicare (A) The Secretary should implement the proposed prospective payment system for home health services on October 1, 2000. To the extent possible, she also should refine the system’s case-mix adjustment before it is implemented.	Delivery system reforms Post-acute care	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (B) The Secretary should vigorously monitor home health agency behavior under the prospective payment system.	Post-acute care	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (C) The Congress should require that HCFA establish a prospective payment system for home health goods and services that blends fixed episode payments and per-visit payments.	Delivery system reforms Post-acute care	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (D) The Secretary should use routinely collected data to refine the case-mix weights over time.	Post-acute care	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (E) The Secretary should use a home health agency wage index to adjust the prospective payment system rates for local wages.	Post-acute care	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (F) The Secretary should establish systems for routinely assessing the quality of post-acute care and should use the information these systems generate to: evaluate the effects of new payment systems on quality of care, focus quality assurance activities, facilitate continuous quality improvement, and promote informed patient decision making.	Post-acute care Quality	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (G) The Secretary should coordinate systems for monitoring post-acute care quality across all service settings to: assess important aspects of the care uniquely provided in a particular setting, compare certain processes and outcomes of care provided in alternative settings, and evaluate the quality of care furnished in multiple-provider episodes of post-acute care.	Post-acute care Quality	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (H) The Secretary should sponsor the development of post-acute care quality measures needed to monitor outcomes- such as beneficiary health and functional status- and the appropriate use of services.	Post-acute care Quality	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (I) The Secretary should review all post-acute care data collection requirements. Each item should have an explicit rationale, and only information needed for accurate billing, risk adjustment, or quality measurement should be required.	Post-acute care Quality	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (K) The Commission recommends continuing the existing policy of adjusting per case payments through an expanded transfer policy when a short length of stay results from a portion of the patient’s care being provided in another setting.	Hospital Post-acute care	March 2000