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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) Date

Developing input-price indexes for all health care settings

To implement an occupation-mix adjusted wage index in fiscal year 2005, the Secretary should collect data on wage rates by occupation in the fiscal year 2002 Medicare cost reports. Hospital-specific wage rates for each occupation should be supplemented by data on the mix of occupations for each provider type. The Secretary also should continue to… Read more »

  • Hospital

March 2001

Financial performance and inpatient payment issues for PPS hospitals (A)

The inpatient PPS operating update of market basket minus 0.55 percent set in law for fiscal year 2002 will provide a reasonable level of payments.

  • Hospital

March 2001

Financial performance and inpatient payment issues for PPS hospitals (B)

In collecting sample patient-level data, HCFA should seek to balance the goals of minimizing payment errors and furthering understanding of the effects of coding on case-mix change.

  • Hospital

March 2001

Financial performance and inpatient payment issues for PPS hospitals (C)

Although the Benefits Improvement and Protection Act of 2000 improved the equity of the hospital disproportionate share adjustment, Congress still needs to reform this adjustment by: * Including the costs of all poor patients in calculating low-income shares used to distribute disproportionate share payments, and * Using the same formula to distribute payments to all… Read more »

  • Hospital

March 2001

Financial performance and inpatient payment issues for PPS hospitals (D)

The Congress should protect urban hospitals from the adverse effect of nearby hospitals being reclassified to areas with higher wage indexes by computing each area’s wage index as if none of the hospitals located in the area had been reassigned.

  • Hospital
  • Regional issues

March 2001

Reducing beneficiary coinsurance under the hospital outpatient prospective payment systems

Congress should continue the reduction in outpatient coinsurance to achieve a 20 percent coinsurance rate by 2010.

  • Beneficiaries and coverage
  • Hospital

March 2001

Treatment of the initial residency period in Medicare’s direct graduate medical education payments

The Congress should eliminate the weighting factors that currently determine Medicare’s direct graduate medical education payments and count all residencies equally through completion of residents’ first specialty or combined program and subspecialty if one is pursued. Residents training longer than the minimum number of years required for board eligibility in a specialty, combined program, or… Read more »

  • Hospital

March 2001

Updating payments for physician services and for care provided in hospital outpatient departments (C)

The Secretary should not use an expenditure target to update the conversion factor in the outpatient prospective payment system or to update payments for other ambulatory care settings.

  • Ambulatory care settings
  • Hospital

March 2001

Updating payments for physician services and for care provided in hospital outpatient departments (D)

The Congress should require an annual update of the conversion factor in the outpatient prospective payment system that is based on the relevant factors influencing the costs of efficiently providing hospital outpatient care, and not just the change in input prices.

  • Hospital

March 2001

Assessing the design and impact of the hospital outpatient prospective payment system (A)

The Secretary should monitor changes in practice patterns across ambulatory care settings to ensure that differences in payment do not lead to inappropriate shifts in site of care.

  • Ambulatory care settings
  • Delivery system reforms
  • Hospital

June 2000