The Medicare Payment Advisory Commission (MedPAC) met Sept. 8-9 to discuss various Medicare issues, including an overview of Medicare payment policies for the coming year, health care spending growth and projections, the effect on the federal budget, and challenges faced by Medicare, in particular, the price differences across health care settings.
MedPAC analysis shows that spending on outpatient hospital and laboratory services remained constant despite the recession when, by contrast, spending growth on other services was dramatically lower. MedPAC staff also provided an overview of the medical device industry, Food and Drug Administration (FDA) regulation of medical devices, and Medicare payment methodology. Commissioners agreed that the impact of implantable medical devices on Medicare spending is significant enough to warrant additional attention, including the use of unique device identifiers (UDIs) as they relate to patient safety.
Additionally, the commission discussed the data analysis regarding physician affiliation and practice sizes. The SK&A office-based physician database analysis concluded that there is an increase in physicians reporting hospital or health system affiliations and physician group sizes are similar in the number of solo physicians. One commissioner stated there should be a more in-depth analysis to answer questions, including how practice size impacts utilization or whether a multi-specialty group impacts coordination of care.
The commissioners also reviewed the previous work done in developing a unified prospective payment system (PPS) for Post-Acute Care (PAC) as required by the IMPACT Act of 2014 (H.R. 4994). In support of a potential accelerated PPS for PAC, MedPAC staff outlined their plan to address quality outcome measures. An analysis will be conducted on readmissions and Medicare spending per beneficiary (MSPB) standardized across all PAC settings.
MedPAC staff also presented an option for making a policy recommendation requiring hospitals to collect patient assessment data at discharge for those going to PAC setting. No specific discussion occurred on the policy recommendation. The measure results will be presented in the spring and recommendations will be made in the June 2017 report.