By law, the Medicare Payment Advisory Commission reports to the Congress each March on the Medicare fee-for-service (FFS) payment systems. We evaluate the adequacy of FFS Medicare’s payments and make recommendations for how those payments should be updated for the policy year in question (in this report, 2026). In this report, we make recommendations for the following FFS payment systems: acute care hospital inpatient and outpatient services, physicians and other health professional services, outpatient dialysis facilities, skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and hospice providers.
The Commission is also required by law to report to the Congress each March on the Medicare Advantage (MA) program and Medicare’s prescription drug program (Part D). In this report, we provide a status report on MA, including recent trends in enrollment, plan offerings, and Medicare’s payment to plans, and we discuss issues such as MA coding intensity, favorable selection, and market concentration. We also provide a status report on Part D that, in addition to providing information on recent trends in enrollment and plan offerings, describes the expected effects of significant changes happening in 2025, as implementation of the Inflation Reduction Act of 2022 continues.
In this year’s report, we also include a status report on ambulatory surgical centers and a chapter that describes our recommendation to improve beneficiaries’ access to inpatient psychiatric care by eliminating both the 190-day lifetime limit on covered days in freestanding inpatient psychiatric facilities and the reduction in the number of covered inpatient psychiatric days available to some beneficiaries during their initial benefit period.
In Appendix A, we list all of this year’s recommendations and the commissioners’ votes.