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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

The Medicare Advantage program (F)

The Congress should put into law the scheduled phase-out of the hold-harmless policy that offsets the impact of risk adjustment on aggregate payments through 2010.

  • Part C (Medicare Advantage)

June 2005 - Chapter 3

Medicare+Choice payment and eligibility policy (B)

The Congress should allow all beneficiaries with end-stage renal disease to enroll in private plans.

  • Ambulatory care settings
  • Beneficiaries and coverage
  • Part C (Medicare Advantage)

March 2004 - Chapter 4

Medicare+Choice payment and eligibility policy

The Congress should establish a quality incentive payment policy for all Medicare Advantage plans.

  • Delivery system reforms
  • Part C (Medicare Advantage)

March 2004 - Chapter 4

What next for Medicare+Choice?

The Congress should set payments to Medicare+Choice plans at 100 percent of per capita local fee-for-service spending as soon as possible, and an adequate risk-adjustment mechanism should be phased in at least as rapidly as called for in current law.

  • Part C (Medicare Advantage)

March 2002 - Chapter 4

Reconciling Medicare+Choice payments and fee-for-service spending (A)

The Medicare program should be financially neutral as to whether beneficiaries enroll in Medicare+Choice plans or in the traditional Medicare program. Therefore, Congress should make Medicare payments for beneficiaries in the two sectors of a local market substantially equal, after accounting for risk.

  • Part C (Medicare Advantage)

March 2001 - Chapter 7

Reconciling Medicare+Choice payments and fee-for-service spending (B)

The Secretary should study variation in spending under the traditional Medicare program to determine how much is caused by differences in input prices and health risk and how much is caused by differences in provider practice patterns, the availability of providers and services, and beneficiary preferences. He should report to the Congress and make recommendations… Read more »

  • Part C (Medicare Advantage)

March 2001 - Chapter 7

Reconciling Medicare+Choice payments and fee-for-service spending (C)

The Secretary should study how beneficiaries, providers, and insurers each benefit from the additional Medicare+Choice payments made in floor counties.

  • Part C (Medicare Advantage)

March 2001 - Chapter 7

Reconciling Medicare+Choice payments and fee-for-service spending (D)

In defining local payment areas, the Secretary should explore using areas that contain sufficient numbers of Medicare beneficiaries to produce reliable estimates of spending and risk.

  • Part C (Medicare Advantage)
  • Regional issues

March 2001 - Chapter 7

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