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.
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Medicare+Choice: A Program in Transition (A)It is too soon to tell whether recent departures from the Medicare managed care program stem from systematic problems with the level or distribution of payment. The Commission plans to monitor and analyze the characteristics of departing plans and the areas they leave and consider general patterns of organization participation, benefits offered, and enrollment. Accordingly,… Read more » |
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Medicare+Choice: A Program in Transition (B)The Secretary should continue to work with organizations offering plans and other interested parties to identify specific regulations or other program policies for which changes, delays in implementation, or administrative flexibility might reduce the burden of compliance without compromising the objectives of the Medicare+Choice program. |
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Medicare+Choice: A Program in Transition (C)As quickly as feasible, the Secretary should develop the capability to use diagnosis data from all sites of care for risk adjustment. |
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Medicare+Choice: A Program in Transition (D)The Secretary’s plan to phase in the interim risk adjustment system- with a method that uses a weighted blend of the payment amounts that would apply under the interim system and those that would apply under the current system- is sound. The weight on the interim payment amounts should be back-end loaded. That is, the… Read more » |
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Medicare+Choice: A Program in Transition (E)The Congress should move the deadline for the adjusted community rate proposal submission to later in the year to allow organizations to include more of their cost information and more details of Medicare payment methods in their projections. |
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Medicare+Choice: A Program in Transition (F)Medicare+Choice organizations should continue to have the flexibility to tailor their benefit packages within their service areas as long as Medicare payments vary by county within a service area. Without this flexibility, organizations may withdraw from counties with lower payments, reducing beneficiary access to new options. |
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Post-Acute Care Providers: Moving toward Prospective Payment (A)The Secretary should collect a core set of patient assessment information across all post-acute settings. |
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Post-Acute Care Providers: Moving toward Prospective Payment (B)The Secretary should establish quality monitoring systems for post-acute care as prospective payment systems are implemented. |
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Post-Acute Care Providers: Moving toward Prospective Payment (C)The Secretary should conduct a demonstration to assess the potential of the Functional Independence Measure-Function Related Groups classification system to predict the resource use of intensive rehabilitation patients in skilled nursing facilities. |
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Post-Acute Care Providers: Moving toward Prospective Payment (D)The Secretary should continue to refine the classification system used in the skilled nursing facility prospective payment system to improve its ability to predict the resources associated with nontherapy ancillary services. |
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