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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
Graduate medical education financing: Focusing on educational priorities (4) The Secretary should report to the Congress on how residency programs affect the financial performance of sponsoring institutions and whether residency programs in all specialties should be supported equally.	Hospital Physicians and other health professionals	June 2010
Graduate medical education financing: Focusing on educational priorities (5) The Secretary should study strategies for increasing the diversity of our health professional workforce (e.g., increasing the shares from underrepresented rural, lower income, and minority communities) and report on what strategies are most effective to achieve this pipeline goal.	Delivery system reforms Physicians and other health professionals	June 2010
Ambulatory surgical centers The Congress should implement a 0.6 percent increase in payment rates for ambulatory surgical center services in calendar year 2011 concurrent with requiring ambulatory surgical centers to submit cost and quality data	Ambulatory care settings	March 2010
Home health services (1) The Congress should eliminate the market basket update for 2011 and direct the Secretary to rebase rates for home health care services to reflect the average cost of providing care.	Post-acute care	March 2010
Home health services (2A) The Congress should direct the Secretary to expeditiously modify the home health payment system to protect beneficiaries from stinting or lower quality of care in response to rebasing. The approaches should include risk corridors and blended payments that mix prospective payment with elements of cost-based reimbursement.	Delivery system reforms Post-acute care	March 2010
Home health services (2B) The Secretary should identify categories of patients who are likely to receive the greatest clinical benefit from home health care and develop outcomes measures that evaluate the quality of care for each category of patient.	Post-acute care Quality	March 2010
Home health services (2C) The Congress should direct the Secretary to review home health agencies that exhibit unusual patterns of claims for payment. The Congress should provide the authority to the Secretary to implement safeguards, such as a moratorium on new providers, prior authorization, or suspension of prompt payment requirements, in areas that appear to be high risk.	Post-acute care	March 2010
Hospice The Congress should update the payment rates for hospice for fiscal year 2011 by the projected rate of increase in the hospital market basket index less the Commission’s adjustment for productivity growth.	Post-acute care	March 2010
Hospital inpatient and outpatient services (1) The Congress should increase payment rates for the acute inpatient and outpatient prospective payment systems in 2011 by the projected rate of increase in the hospital market basket index, concurrent with implementation of a quality incentive payment program.	Hospital Quality	March 2010
Hospital inpatient and outpatient services (2) To restore budget neutrality, the Congress should require the Secretary to fully offset increases in inpatient payments due to hospitals’ documentation and coding improvements. To accomplish this goal, the Secretary must reduce payment rates in the inpatient prospective payment system by the same percentage (not to exceed 2 percentage points) each year in 2011, 2012,… Read more »	Hospital	March 2010