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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
Hospital inpatient and outpatient services The Congress should: Replace Medicare’s current hospital quality programs with a new hospital value incentive program (HVIP) that: includes a small set of population-based outcome, patient experience, and value measures; scores all hospitals based on the same absolute and prospectively set performance targets; accounts for differences in patients’ social risk factors by distributing payment adjustments… Read more »	Hospital Quality	March 2019
Inpatient rehabilitation facility services For 2020, the Congress should reduce the fiscal year 2019 Medicare base payment rate for inpatient rehabilitation facilities by 5 percent. Additionally, the Commission reiterates its March 2016 recommendations on the inpatient rehabilitation facility prospective payment system.	Post-acute care	March 2019
Long-term care hospital services For 2020, the Secretary should increase the fiscal year 2019 Medicare base payment rates for long-term care hospitals by 2 percent.	Post-acute care	March 2019
Outpatient dialysis services For calendar year (CY) 2020, the Congress should update the CY 2019 Medicare end-stage renal disease prospective payment system base rate by the amount determined under current law.	Ambulatory care settings	March 2019
Physician and other health professional services For calendar year 2020, the Congress should increase the calendar year 2019 payment rates for physician and other health professional services by the amount specified in current law.	Physicians and other health professionals	March 2019
Skilled nursing facility services (1) The Congress should proceed to revise the skilled nursing facility prospective payment system in fiscal year 2020 and should annually recalibrate the relative weights of the case-mix groups to maintain alignment of payments and costs.	Post-acute care	March 2019
Skilled nursing facility services (2) The Congress should eliminate the fiscal year 2020 update to the Medicare base payment rates for skilled nursing facilities.	Post-acute care	March 2019
Using payment to ensure appropriate access to and use of hospital emergency department services (1) The Congress should: allow isolated rural stand-alone emergency departments (more than 35 miles from another emergency department) to bill standard outpatient prospective payment system facility fees and provide such emergency departments with annual payments to assist with fixed costs.	Hospital Regional issues	June 2018
Using payment to ensure appropriate access to and use of hospital emergency department services (2) The Congress should reduce Type A emergency department rates by 30 percent for off-campus stand-alone emergency departments that are within six miles of an on-campus hospital emergency department.	Hospital Regional issues	June 2018
Ambulatory surgical center services The Congress should eliminate the calendar year 2019 update to the Medicare payment rates for ambulatory surgical centers. The Congress should also require ambulatory surgical centers to submit cost data.	Ambulatory care settings	March 2018