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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

Improving payment for end-stage renal disease services (D)

HCFA should collect information on ESRD patients’ satisfaction with the quality of and access to care.

  • Ambulatory care settings

March 2000 - Chapter 6

Improving payment for end-stage renal disease services (E)

Once HCFA has implemented a risk-adjusted payment system and a system to monitor and report on the quality of care, the Congress should lift the bar prohibiting patients with ESRD from enrolling in Medicare+Choice.

  • Ambulatory care settings
  • Part C (Medicare Advantage)

March 2000 - Chapter 6

Improving payment for end-stage renal disease services (F)

ESRD patients who lose Medicare+Choice coverage because their plan leaves the area should be permitted to enroll in another Medicare+Choice plan.

  • Ambulatory care settings
  • Part C (Medicare Advantage)

March 2000 - Chapter 6

Medicare beneficiaries’ access to quality health care (A)

The Secretary should periodically identify potential problems in beneficiaries’ access to care that arise in the evolving Medicare program and should report annually to the Congress on findings from studies undertaken to examine those potential problems.

  • Quality

March 2000 - Chapter 2

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 - Chapter 3

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 - Chapter 3

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 - Chapter 3

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 - Chapter 3

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 - Chapter 3

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 - Chapter 3