MedPAC’s September 2022 public meeting will be held virtually via video conference on the GoToWebinar platform.
Agenda
09/01/2022 . 11:45 am - 1:00 pm
Context for Medicare payment policy
Staff Contacts:
ISSUE: Each year, the Commission includes a context chapter in its March Report to the Congress that describes Medicare’s overall financial situation.
KEY POINTS: The context chapter outlines the factors contributing to Medicare’s financing challenges and is meant to serve as a backdrop for MedPAC’s discussions and recommendations over the coming year.
ACTION: Commissioners will discuss the draft chapter.
09/01/2022 . 2:15 pm - 3:40 pm
Standardizing benefits in Medicare Advantage plans: Cost sharing for Part A and Part B services
Staff Contacts:
ISSUE: MA benefit packages vary substantially, potentially confounding beneficiaries’ ability to meaningfully choose a plan.
KEY POINTS: The number of MA plans being offered has grown steadily in recent years and the average beneficiary now has more than 30 plans available. The benefits that MA plans offer vary, which can make it difficult for beneficiaries to compare plans and select the one that best meets their needs. Standardized benefit packages could be used as a way to make that process easier. We examine how standardized benefits have been used in other health insurance markets and the variation in MA cost sharing for Part A and Part B services, and discuss some key issues that policymakers would need to address if they wanted to standardize MA benefits.
ACTION: Commissioners will discuss the material and provide guidance on future work.
09/01/2022 . 3:45 pm - 5:00 pm
Medicare Advantage encounter data
Staff Contacts:
ISSUE: MA plans are required to submit detailed information about each encounter an enrollee has with a health care provider. The accuracy and completeness of this information is important, as CMS uses diagnoses identified in encounter data to calculate MA enrollee risk scores. As described in the Commission’s June 2019 report to the Congress, our previous evaluation of MA encounter data found significant data errors and omissions.
KEY POINTS: The Commission continues to monitor the accuracy and completeness of encounter data.
ACTION: Commissioners will review and discuss updated information on encounter data.
09/02/2022 . 9:00 am - 10:25 am
Reforming Medicare's wage index systems
Staff Contacts:
ISSUE: The role of the Medicare wage index is to adjust the national base payment rates in the inpatient and other prospective payment systems (IPPS) for differences in wage rates across geographic areas. In 2007, the Commission recommended an alternative method to compute the wage index. However, since then, Congress and CMS have added additional adjustments to an already complex system.
KEY POINTS: The Commission remains concerned about Medicare’s current wage index policies, including the system’s inaccuracy, the circularity of hospital-reported data, the large volume of permitted exceptions, and administrative complexity.
ACTION: Commissioners will review key concerns and discuss an alternative wage index method.
09/02/2022 . 10:30 am - 12:00 pm
Addressing high prices of drugs covered under Medicare Part B
Staff Contacts:
ISSUE: Historically, Medicare has had only an indirect influence on how drugs are priced. Medicare has lacked or has not used tools to strike a balance between providing financial rewards for innovation with value and affordability of care for beneficiaries and taxpayers. Medicare also lacks tools to promote price competition among drugs with therapeutic alternatives.
KEY POINTS: In the Commission’s June 2022 report to the Congress, we described alternative approaches for Medicare to address (1) high prices for new Part B drugs with limited clinical evidence, (2) lack of price competition for drugs with similar health effects, and (3) financial incentives associated with the percentage add-on to Medicare Part B’s payment rate.
ACTION: Commissioners will continue to review and refine potential policy approaches.