MedPAC Publishes Annual June Report
June 18, 2004 - The Medicare Payment Advisory Commission
(MedPAC) June 15 published its annual June report
to Congress. The report examines select Medicare issues including,
long-term care hospitals, implementation of the Medicare drug benefit,
and the Chronic Care Improvement Program created in the Medicare
prescription drug bill.
Long-term care hospitals (LTCHs) provide post-acute care to a small
number of severely ill patients. MedPAC's report finds that the
supply of LTCHs is a strong predictor of their use. LTCH patients
usually cost Medicare more than similar patients in alternative
settings (e.g., SNFs, acute care hospitals) except for patients
that are the sickest. The report recommends that long-term care
hospitals be defined by facility and patient level criteria that
better differentiate their services and describe the characteristics
of patients that will benefit the most from their care.
There are several policy questions as the Medicare prescription
drug benefit is implemented. The June report examines how formulary
systems are established and maintained, including defining therapeutic
categories, operating pharmacy and therapeutics committees, and
designing the appeals process. In addition, the section considers
the issues arising when drug plans enter or exit markets or beneficiaries
switch plans, including arranging the prior approval of off-formulary
drugs and informing physicians, pharmacists, and beneficiaries of
changes in formularies, cost sharing, and other procedures.
The goal of the Medicare Chronic Care Improvement Program is to
see if there is a model of care coordination that improves care
for Medicare beneficiaries and reduces program spending. It will
focus on beneficiaries with diabetes, congestive heart failure,
and chronic obstructive pulmonary disease. The program will also
educate patients about self-care, and promote the use of evidence-based
treatment guidelines.
Other issues addressed in the report include:
- The estimate of the payment update for physician
services;
- Beneficiaries eligible for Medicare and Medicaid;
- Healthcare purchasing strategies;
- Medicare's hospice benefit; and
- Information technology in healthcare
Information:
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
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