New section

Content Background

New section

MedPAC Releases March 2018 Report to Congress, Recommends Annual Medicare Payment Adjustments

March 16, 2018

New section

New section

PRESS CONTACTS
Phoebe Ramsey, Sr. Regulatory Analyst, Quality & Payment Policy

The Medicare Payment Advisory Commission (MedPAC) March 15 released its March 2018 Report to Congress. It recommends annual adjustments for Medicare’s various payment systems, including the currently authorized updates of 1.25 percent for inpatient and outpatient care.

MedPAC continues to make recommendations for fee for service (FFS) payments to ensure that high-quality care is delivered to Medicare beneficiaries while at the same time giving providers incentives to constrain cost growth. The commission’s payment rate recommendations are based on assessments of payment adequacy that examines beneficiaries’ access to care, the quality of care they receive, providers’ access to capital, and providers’ costs and Medicare’s payments. While the commission does not recommend any payment updates for 2019 for four FFS payment systems (long-term care hospital, hospice, ambulatory surgical center (ASC), and skilled nursing facility (SNF)), it encourages Medicare to require ASCs to submit cost data to improve payment accuracy.

The commission formalized its recommendation that the Congress eliminate the Merit-based Incentive Payment System (MIPS) and establish a new voluntary value program in FFS Medicare where clinicians can elect to be measured as part of a voluntary group and qualify for a value payment based on that group’s performance on a set of population-based quality measures. This recommendation is based on their analysis that MIPS is overly burdensome on clinicians and will not succeed in helping Medicare beneficiaries choose clinicians, clinicians change practice patterns to improve value, or the Medicare program rewarding clinicians based on value.

For inpatient and hospital services, the commission recommends that Congress update inpatient and outpatient payment rates by the amounts specified in current law (1.25 percent). Although hospitals with excess capacity have an incentive to see more Medicare beneficiaries, payment rates remain about eight percent higher than the costs associated with Medicare patients.

Additionally, for the post-acute payment systems, the commission recommends reductions of five percent of the base payment for the home health and inpatient rehabilitation facility (IRF) payment systems. More broadly, MedPAC recommends that the post-acute care sectors be brought together under a unified payment system that would base payments on patient characteristics, and that as an initial step towards this recommendation, that relative weights in each setting-specific payment system be blended with those of the unified post-acute-care system described back in June 2016.

The commission provides status reports on the Medicare Advantage (MA) and the Part D prescription drug programs. As part of these reports, MedPAC recommends that MA plan quality assessments change when MA contracts are consolidated and expanding the Part D coverage-gap discount to biosimilar drugs.

Finally, the commission provided a report mandated by the 21st Century Cures Act in regards to telehealth services in the Medicare program.

New section

Left Patch