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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

Revising payment methods and monitoring quality of care in traditional Medicare (J)

The Congress should combine prospective payment system operating and capital payment rates to create a single prospective rate for hospital inpatient care. This change would require a single set of payment adjustments- in particular, for indirect medical education and disproportionate share hospital payments- and a single payment update.

  • Delivery system reforms
  • Hospital

March 2000 - Chapter 3

Access to home health services (C)

If the Congress is not confident that the Secretary can implement a prospective payment system for home health services by 2000, then it should explore the feasibility of establishing a process for agencies to exclude a small share of their patients from the aggregate per-beneficiary limits. Such a policy should be implemented in a budget-neutral… Read more »

  • Delivery system reforms
  • Post-acute care

June 1999 - Chapter 6

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 »

  • Delivery system reforms
  • Part C (Medicare Advantage)

March 1999 - Chapter 2

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

The Secretary should explore the potential for revising the rehabilitation groups of the classification system used in the skilled nursing facility prospective payment system to reduce reliance on measurements of rehabilitation time.

  • Delivery system reforms
  • Post-acute care

March 1999 - Chapter 5

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

The Secretary should develop a discharge-based prospective payment system for rehabilitation facility patients based on the Functional Independence Measure-Function Related Groups classification system. Policies to address transfers and short-stay outliers would be necessary components of such a system.

  • Delivery system reforms
  • Post-acute care

March 1999 - Chapter 5