MedPAC Reviews Medicare Advantage and Medicare Enrollment 

The Medicare Payment Advisory Commission (MedPAC) met March 2-3 to discuss Medicare Advantage (MA), beneficiary enrollment decisions in Medicare, and Medicare Part B premiums. Commissioners began with a preliminary review of MA provider networks, finding that while most clinicians participate in these networks, their participation is not static, meaning that they may move in or out of network over time. MedPAC found that over 74% of primary care providers and 76% of specialists participate in three or more MA organizations but may move from plan to plan throughout the year, potentially creating disruption for beneficiaries. Commissioners concluded the first day by reviewing an analysis of scenarios the Centers for Medicare & Medicaid Services (CMS) could adopt to implement MA encounter data into the risk adjustment model used to determine benchmarking and payments to MA plans. MedPAC addressed this in response to the CMS’ suggestion that it could introduce such a model by 2027. This will not appear as a chapter in the 2026 reports to Congress, but commissioners noted they may revisit in the future.   

On the second day of its convening, MedPAC reviewed Medicare enrollment decisions for beneficiaries, including considerations surrounding the timing of enrollment. Commissioners stated they will build on this presentation at the April meeting and plan to include an informational chapter in the commission’s June 2026 report to Congress. Lastly, MedPAC discussed how Medicare Part B Premium payment is determined, with potential plans to continue this work in future sessions.