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MedPAC Discusses Improving Physician Fee Schedule Payment Accuracy, EHR Payments

April 13, 2012—The Medicare Payment Advisory Commission (MedPAC) April 5 and 6 met to discuss a variety of topics, including how to collect data to improve the accuracy of payments under the physician fee schedule (PFS) and an update on Medicare electronic health records (EHR) incentive payments.

Currently, MedPAC is collecting data to address two issues: addressing the longstanding concern around equity and accuracy of fee schedule payments; and addressing and implementing the recommendation in the commission’s October letter on the sustainable growth rate (SGR) formula to refine the PFS through targeted data collection and reducing payments for overpriced services.  Commission staff presented two research approaches that MedPAC is undertaking: a bottom-up service-by-service approach with RTI International in primary data collection through EHRs and direct observation; and an ongoing top-down examination with the University of Minnesota to test methods for collecting time and service volume data.  Commissioners discussed the various strengths and weaknesses in these approaches to best inform the Centers for Medicare and Medicaid Services’ (CMS’) decision on how to collect time data. 

Commission staff also presented an update on the Medicare EHR incentive program, giving commissioners an overview of the program thus far.  Commissioners discussed what MedPAC’s potential role could be in the area of EHR incentives, perhaps assessing if incentives are adequate, and examining how these incentives could translate to other areas besides physicians and hospitals.

Other topics covered at the meeting included CMS demonstrations for dual-eligible beneficiaries, reform of Medicare’s benefit design, Medicare payment for ambulance services, care coordination in fee-for-service Medicare, and variation in private-sector payments rates.

Staff presentations and the meeting transcript are available on MedPAC’s Web site

Staff Contact:

Jane Eilbacher
Policy and Regulatory Specialist
Telephone: 202-828-0896


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806