The MedPAC Blog

  • Data book highlight: Rates of low-value service use and spending in Medicare

    by MedPAC Staff | Aug 23, 2016
    On Friday, MedPAC released its July 2016 data book. The data book is an annual MedPAC publication filled with charts and tables presenting much of the information from our March report, plus more, in a convenient and accessible reference guide. In this post, we’re highlighting two charts (5-7 and 5-8) about low-value care that can be found in this year’s edition.
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  • MedPAC releases drug briefings

    by MedPAC Staff | Jun 16, 2016
    When the Commission began its deliberations on drug policy, which ultimately shaped the contents of the June report, it started with two informational presentations that were intended to provide background and context for its discussions. The Commission is now releasing annotated versions of these presentations to serve as a resource for policymakers.
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  • Case mix, coding, and profitability in IRFs

    by MedPAC Staff | May 17, 2016
    The high margin for IRFs in 2014 indicates that, in aggregate, Medicare payments substantially exceed the costs of caring for beneficiaries. But margins differ considerably across IRFs. Since 2009, the aggregate margin for hospital-based IRFs—which account for 52 percent of IRF discharges—has been at or below 1 percent, while the aggregate margin for freestanding IRFs has been 20 percent or more. Further, since 2006, the disparity between hospital-based and freestanding IRFs’ margins has been widening. The growing disparity is likely due in part to differences in cost growth.
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  • March 2016 report highlight: HRAs and risk adjustment

    by MedPAC Staff | Apr 26, 2016
    MedPAC’s March 2016 report contains two recommendations for the Medicare Advantage (MA) program. This post will focus on the MA recommendation pertaining to health risk assessments (HRAs).
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  • Including hospice benefit in the MA benefit package

    by MedPAC Staff | Feb 19, 2016
    The Medicare hospice benefit is not included in the Medicare Advantage (MA) benefits package. MA enrollees who elect hospice remain in their MA plans, but fee-for-service (FFS) Medicare pays for their hospice services. This carve-out of hospice from MA fragments care accountability and financial responsibility for MA enrollees who elect hospice.
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  • Price growth of brand-name drugs and Part D

    by MedPAC Staff | Jan 27, 2016
    Evidence suggests that price growth for brand-name drugs is beginning to drive growth in average prices of all drugs covered under Part D.
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  • MedPAC examines MA and Part D plan accessibility

    by MedPAC Staff | Jan 19, 2016
    Every year, the Commission provides a status report on the Medicare Advantage (MA) and Part D programs. These reports were presented at our December and January meetings. To monitor each program’s performance, we examine enrollment trends, and plan availability for the coming year, as well as a variety of other factors.
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  • MedPAC presents new marginal cost analysis

    by MedPAC Staff | Dec 21, 2015
    This year, in addition to its traditional margin calculation, the Commission is considering a new aspect of the relationship between Medicare payments and providers’ costs: Medicare payments relative to providers’ marginal costs, i.e. marginal profit.
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  • Understanding MACRA's new approach to updating clinician payments

    by MedPAC Staff | Dec 01, 2015
    The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the sustainable growth rate (SGR) system and established a new approach to updating payments to clinicians. In order to implement MACRA, CMS will need to conduct rulemaking over the next two years to establish specific definitions for the APM and MIPS payment paths. This post provides a guide to some of the key requirements of the law.
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  • Models for preserving access to emergency care in rural areas

    by MedPAC Staff | Nov 24, 2015
    The Commission has consistently stated that rural beneficiaries’ access to emergency services needs to be preserved. Since January 2013, there have been 41 hospital closures in rural counties and rural parts of urban communities. While some closures reflect excess capacity in areas, in other cases, the closed hospital has been the sole emergency room in the area. It is both the concern over maintaining access to care and concerns over inefficiencies in the current delivery system that motivated the Commission’s October session on preserving rural access to emergency services.
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