MedPAC’s September 2023 public meeting was held virtually via video conference on the GoToWebinar platform.
Agenda
09/07/2023 . 10:45 am - 12:00 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.
09/07/2023 . 1:15 pm - 1:55 pm
Medicare Advantage: MedPAC workplan
Staff Contacts:
ISSUE: As of this year, a majority of beneficiaries with Part A and Part B coverage are enrolled in Medicare Advantage (MA) plans. Optimizing the MA program is critical for both beneficiaries and Medicare.
KEY POINTS: During this analytic cycle, we will continue to examine important aspects of the MA program, including plan enrollment and availability, access and quality, benefit standardization, risk adjustment and coding intensity, favorable selection, trends in the market for dual-eligible special needs plans, and the completeness of encounter data.
ACTION: Commissioners will review and discuss the MA workplan.
09/07/2023 . 2:00 pm - 3:30 pm
Standardized benefits in Medicare Advantage plans
Staff Contacts:
ISSUE: MA plans can develop their own cost-sharing rules and cover a wide variety of supplemental benefits. As a result, plan benefit packages vary substantially, which may make it difficult for beneficiaries to meaningfully choose a plan.
KEY POINTS: This session will build on the Commission’s discussion of standardized benefits during our prior meeting cycle. We review last year’s work and provide additional information on the growth in the number of MA plans and the variation in plan benefits at the local market level. We highlight some issues that policymakers would need to consider if they wanted to standardize MA plan benefits.
ACTION: Commissioners will discuss the material and provide guidance on future work.
09/07/2023 . 3:35 pm - 5:00 pm
Improving MedPAC’s estimate of Medicare Advantage coding intensity
Staff Contacts:
ISSUE: Using a cohort method, the Commission has estimated that higher Medicare Advantage (MA) coding intensity has increased MA risk scores above FFS risk scores for similar beneficiaries in each year since 2007. A different method of estimating the impact of MA coding intensity, the demographic estimate of coding intensity (DECI), has produced estimates of coding intensity that are double the estimates produced by MedPAC’s method.
KEY POINTS: Examination of MedPAC’s cohort method and the DECI method are necessary to pinpoint the reasons for the differing estimates and to more accurately determine the impact of MA coding intensity.
ACTION: Commissioners will review and discuss the findings.
09/08/2023 . 9:00 am - 10:25 am
Medicare’s Acute Care Hospital at Home program
Staff Contacts:
ISSUE: For many years hospitals and payers have experimented with providing acute hospital care in a beneficiary’s home in place of the traditional stay at a hospital. CMS established the Acute Care Hospital at Home (ACHaH) program in November 2020.
KEY POINTS: The ACHaH program is scheduled to continue through December 2024. Lack of data and selection issues will make it difficult to assess the impact of the program on costs and quality of care.
ACTION: Commissioners will review and discuss the findings.
09/08/2023 . 10:30 am - 11:30 am
Ambulatory Surgical Centers: A primer
Staff Contacts:
ISSUE: Surgical procedures provided in ambulatory surgical centers (ASCs) have been covered by Medicare since 1982. The shift of some surgical procedures from hospital outpatient departments (HOPDs) to ASCs offers some advantages for beneficiaries, Medicare, and providers.
KEY POINTS: Several factors could be slowing the shift of surgical procedures from HOPDs to ASCs.
ACTION: Commissioners will review and discuss the findings.