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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) Publication

Reducing beneficiary coinsurance under the hospital outpatient prospective payment systems

Congress should continue the reduction in outpatient coinsurance to achieve a 20 percent coinsurance rate by 2010.

  • Beneficiaries and coverage
  • Hospital

March 2001 - Chapter 9

Treatment of the initial residency period in Medicare’s direct graduate medical education payments

The Congress should eliminate the weighting factors that currently determine Medicare’s direct graduate medical education payments and count all residencies equally through completion of residents’ first specialty or combined program and subspecialty if one is pursued. Residents training longer than the minimum number of years required for board eligibility in a specialty, combined program, or… Read more »

  • Hospital

March 2001 - Chapter 10

Updating payments for physician services and for care provided in hospital outpatient departments (A)

The Congress should replace the sustainable growth rate system with an annual update based on factors influencing the unit costs of efficiently providing physician services.

  • Physicians and other health professionals

March 2001 - Chapter 2

Updating payments for physician services and for care provided in hospital outpatient departments (B)

In implementing the update for physician services, the Congress should require the Health Care Financing Administration to use a forecast of the change in input prices.

  • Physicians and other health professionals

March 2001 - Chapter 2

Updating payments for physician services and for care provided in hospital outpatient departments (C)

The Secretary should not use an expenditure target to update the conversion factor in the outpatient prospective payment system or to update payments for other ambulatory care settings.

  • Ambulatory care settings
  • Hospital

March 2001 - Chapter 2

Updating payments for physician services and for care provided in hospital outpatient departments (D)

The Congress should require an annual update of the conversion factor in the outpatient prospective payment system that is based on the relevant factors influencing the costs of efficiently providing hospital outpatient care, and not just the change in input prices.

  • Hospital

March 2001 - Chapter 2

Assessing the design and impact of the hospital outpatient prospective payment system (A)

The Secretary should monitor changes in practice patterns across ambulatory care settings to ensure that differences in payment do not lead to inappropriate shifts in site of care.

  • Ambulatory care settings
  • Delivery system reforms
  • Hospital

June 2000 - Chapter 2

Assessing the design and impact of the hospital outpatient prospective payment system (B)

The Secretary should study the accuracy of and changes in coding practices with the implementation of the outpatient prospective payment system.

  • Hospital

June 2000 - Chapter 2

Assessing the design and impact of the hospital outpatient prospective payment system (C)

The Congress should enact legislation to accelerate the rate of beneficiary coinsurance buy down under the outpatient prospective payment system and establish a date certain for achieving a coinsurance rate of 20 percent. This date should result in a time frame for implementation consistent with other Medicare payment policy changes.

  • Beneficiaries and coverage
  • Hospital

June 2000 - Chapter 2

Assessing the design and impact of the hospital outpatient prospective payment system (D)

The Secretary should carefully monitor implementation of the outpatient prospective payment system to ensure that: * It does not have unintended, adverse consequences on beneficiaries’ access to care, * It does not compromise the quality of care delivered, and * The annual reductions in beneficiary coinsurance as a share of total payment are realized.

  • Beneficiaries and coverage
  • Hospital

June 2000 - Chapter 2