An official website of the United States Government —

Here’s how you know

Official websites use .gov

A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

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) Date

Post-Acute Care Providers: Moving toward Prospective Payment (O)

The Secretary should evaluate all relevant case-mix and prospective payment methodologies for their utility in developing a prospective payment system for long-term hospitals.

  • Post-acute care

March 1999

Providers Exempt from the Acute Care Prospective Payment System (A)

To update and improve payments to providers exempt from the acute care prospective payment system, the Secretary should increase the market basket amount in the target amount update formula by 0.4 percentage points for fiscal year 2000.

  • Hospital

March 1999

Providers Exempt from the Acute Care Prospective Payment System (B)

The Congress should adjust the wage-related portion of the target amount caps on exempt providers to account for geographic differences in labor costs.

  • Hospital

March 1999

Providers Exempt from the Acute Care Prospective Payment System (C)

To update and improve payments to providers exempt from the acute care prospective payment system, the Secretary should encourage additional research in case-mix classification for psychiatric patients, with an eye toward developing a prospective payment system for them in the future.

  • Hospital

March 1999

Updating and reforming prospective payment for hospital inpatient care (A)

For the annual update to hospital inpatient payments under Medicare’s prospective payment system: The operating update of market basket minus 1.8 percentage points set in law for fiscal year 2000 will provide reasonable payment rates. An update of that level, which will be 0.7 percent if the current market basket estimate holds, is within the… Read more »

  • Hospital

March 1999

Updating and reforming prospective payment for hospital inpatient care (B)

For the annual update to hospital inpatient payments under Medicare’s prospective payment system: The Secretary should increase the capital payment rates for fiscal year 2000 by between market basket minus 3.0 percentage points and market basket minus 0.1 percentage point. With the current estimate of the market basket, this corresponds to an update of -1.1… Read more »

  • Hospital

March 1999

Updating and reforming prospective payment for hospital inpatient care (C)

For Medicare’s disproportionate share payments: The Congress should require that disproportionate share payments be distributed according to each hospital’s share of low-income patient costs, defined broadly to include all care to the poor. The measure of low-income costs should reflect: * Medicare patients eligible for Supplemental Security Income, Medicaid patients, patients sponsored by other indigent… Read more »

  • Hospital

March 1999

Updating and reforming prospective payment for hospital inpatient care (D)

For Medicare’s disproportionate share payments: Through a minimum threshold for low-income share, the formula for distributing disproportionate share payments should concentrate payments among hospitals with the highest shares of poor patients. A reasonable range for this threshold would be levels that make between 50 percent and 60 percent of hospitals eligible for a payment. The… Read more »

  • Hospital

March 1999

Updating and reforming prospective payment for hospital inpatient care (E)

For Medicare’s disproportionate share payments: The Secretary should collect the data necessary to revise the disproportionate share payment system from all hospitals covered by prospective payment.

  • Hospital

March 1999