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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Home health services (2A)The Congress should direct the Secretary to expeditiously modify the home health payment system to protect beneficiaries from stinting or lower quality of care in response to rebasing. The approaches should include risk corridors and blended payments that mix prospective payment with elements of cost-based reimbursement. |
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Home health services (2B)The Secretary should identify categories of patients who are likely to receive the greatest clinical benefit from home health care and develop outcomes measures that evaluate the quality of care for each category of patient. |
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Home health services (2C)The Congress should direct the Secretary to review home health agencies that exhibit unusual patterns of claims for payment. The Congress should provide the authority to the Secretary to implement safeguards, such as a moratorium on new providers, prior authorization, or suspension of prompt payment requirements, in areas that appear to be high risk. |
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HospiceThe Congress should update the payment rates for hospice for fiscal year 2011 by the projected rate of increase in the hospital market basket index less the Commission’s adjustment for productivity growth. |
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Inpatient rehabilitation facility servicesThe update to the payment rates for inpatient rehabilitation facility services should be eliminated for fiscal year 2011. |
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Long-term care hospital servicesThe Secretary should eliminate the update to the payment rate for long-term care hospitals for rate year 2011. |
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Skilled nursing facility servicesThe Congress should eliminate the update to payment rates for skilled nursing facility services for fiscal year 2011. |
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Home health services (1)The Congress should eliminate the market basket increase for 2010 and advance the planned reductions for coding adjustments in 2011 to 2010, so that payments in 2010 are reduced by 5.5 percent from 2009 levels. |
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Home health services (2)The Congress should direct the Secretary to rebase rates for home health care services in 2011 to reflect the average cost of providing care. |
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Home health services (3)The Congress should direct the Secretary to assess payment measures that protect the quality of care and ensure incentives for the efficient delivery of home health care. The study should include alternative payment strategies such as blended payments and risk corridors and outcome-based quality incentives. |
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