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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
Physician services and ambulatory surgical centers (3) The Congress should direct the Secretary to increase the equipment use standard for expensive imaging machines from 25 hours to 45 hours per week. This change should redistribute relative value units from expensive imaging to other physician services.	Physicians and other health professionals	February 2009
Public reporting of physicians’ financial relationships (4) The Congress should require all hospitals and other entities that bill Medicare for services to annually report the ownership share of each physician who directly or indirectly owns an interest in the entity (excluding publicly traded corporations). The Secretary should post this information on a searchable public website.	Hospital Physicians and other health professionals	February 2009
Public reporting of physicians’ financial relationships (5) The Congress should require the Secretary to submit a report, based on the Disclosure of Financial Relationships Report, on the types and prevalence of financial arrangements between hospitals and physicians.	Hospital Physicians and other health professionals	February 2009
A path to bundled payment around a hospitalization (A) The Congress should require the Secretary to confidentially report readmission rates and resource use around hospitalization episodes to hospitals and physicians. Beginning in the third year, providers’ relative resource use should be publicly disclosed.	Hospital Physicians and other health professionals	June 2008
A path to bundled payment around a hospitalization (B) To encourage providers to collaborate and better coordinate care, the Congress should direct the Secretary to reduce payments to hospitals with relatively high readmission rates for select conditions and also allow shared accountability between physicians and hospitals. The Congress should also direct the Secretary to report within two years on the feasibility of broader approaches,… Read more »	Delivery system reforms Hospital Physicians and other health professionals Quality	June 2008
Promoting the use of primary care (A) The Congress should establish a budget-neutral payment adjustment for primary care services billed under the physician fee schedule and furnished by primary-care-focused practitioners. Primary-care-focused practitioners are those whose specialty designation is defined as primary care and/or those whose pattern of claims meets a minimum threshold of furnishing primary case services. The Secretary would use rulemaking… Read more »	Delivery system reforms Physicians and other health professionals	June 2008
Promoting the use of primary care (B) The Congress should initiate a medical home pilot project in Medicare. Eligible medical homes must meet stringent criteria, including at least the following capabilities: * Furnish primary care (including coordinating appropriate preventive, maintenance, and acute health services), * Conduct care management, * Use health information technology for active clinical decision support, * Have a formal… Read more »	Physicians and other health professionals Quality	June 2008
Outpatient dialysis services The Congress should update the composite rate in calendar year 2009 by the projected rate of increase in the end-stage renal disease market basket index less the Commission’s adjustment for productivity growth. The Commission reiterates its recommendation that the Congress implement a quality incentive program for physicians and facilities that treat dialysis patients.	Ambulatory care settings Physicians and other health professionals Quality	February 2008
Physician services The Congress should update payments for physician services in 2009 by the projected change in input prices less the Commission’s adjustment for productivity growth. The Congress should enact legislation requiring CMS to establish a process for measuring and reporting physician resource use on a confidential basis for a period of two years.	Physicians and other health professionals	February 2008
Physician services The Congress should update payments for physician services in 2008 by the projected change in input prices less the Commission’s expectation for productivity growth.	Physicians and other health professionals	March 2007