MedPAC Reviews Medicare Payment Incentives, Pharmacy Access, and Medicare Advantage 

The Medicare Payment Advisory Commission (MedPAC) met on April 9 and 10 to discuss improving payment incentives, preferred networks, and pharmacy access in Part D, and the relationship between Medicare Advantage (MA) enrollment and hospital finances. 

Commissioners began by reviewing payment incentives in Medicare Fee-for-Service, MA, and alternate payment models, including potential future recommendations to improve these incentives. MedPAC will continue to study these payment approaches for improvements and will plan to include a chapter on this work in its June 2026 Report to Congress. Commissioners then continued their review of the status of regional benchmarks and benchmark plan availability in the prescription drug plan market. This was followed by the commissioners' review of trends in pharmacy access and preferred networks in Part D plans, including the effect of pharmacy closures on Part D networks. MedPAC plans to convene focus groups with pharmacists in the next cycle to constitute this work. Lastly, commissioners reviewed the estimated association between MA enrollment and provider financing in the hospital and post-acute care settings. MedPAC found no statistically significant correlation between MA penetration and all-payer margins for hospitals or post-acute care providers. They did find, however, that MA inpatient stays tended to be longer, and greater enrollment in MA may lead to a misalignment in uncompensated care payments. MedPAC will include a chapter on this analysis in the June 2026 report to Congress.