MedPAC > Recommendations

Commission Recommendations

MedPAC makes recommendations to the Congress and to the Secretary of Health and Human Services on issues affecting the administration of the Medicare program. With its recommendations, the Commission strives to improve the delivery of care, while ensuring financial stability and maximizing value for the program. After extensive analysis and evaluation, our recommendations are discussed and voted on by Commissioners in our public meetings. Recommendations are typically published in two main reports, released in March and June of each year.

Recommendations	Topic(s)	Date
Status report on Part D, with focus on beneficiaries with high drug spending The Congress should modify the Part D low-income subsidy copayments for Medicare beneficiaries with incomes at or below 135 percent of poverty to encourage the use of generic drugs when available in selected therapeutic classes. The Congress should direct the Secretary to develop a copay structure, giving special consideration to eliminating the cost sharing for… Read more »	Beneficiaries and coverage Drugs, Devices, and Tests	March 2012
Moving forward from the sustainable growth rate (SGR) system (1) The Congress should repeal the sustainable growth rate (SGR) system and replace it with a 10-year path of statutory fee-schedule updates. This path is comprised of a freeze in current payment levels for primary care and, for all other services, annual payment reductions of 5.9 percent for three years, followed by a freeze. The Commission… Read more »	Delivery system reforms Physicians and other health professionals	October 2011
Moving forward from the sustainable growth rate (SGR) system (2) The Congress should direct the Secretary to regularly collect data—including servicevolume and work time—to establish more accurate work and practice expense values. Tohelp assess whether Medicare’s fees are adequate for efficient care delivery, the datashould be collected from a cohort of efficient practices rather than a sample of all practices.The initial round of data collection… Read more »	Delivery system reforms Physicians and other health professionals	October 2011
Moving forward from the sustainable growth rate (SGR) system (3) The Congress should direct the Secretary to identify overpriced fee-schedule services andreduce their relative value units (RVUs) accordingly. To fulfill this requirement, theSecretary could use the data collected under the process in recommendation 2. Thesereductions should be budget neutral within the fee schedule. Starting in 2015, the Congressshould specify that the RVU reductions achieve an… Read more »	Delivery system reforms Physicians and other health professionals	October 2011
Moving forward from the sustainable growth rate (SGR) system (4) Under the 10-year update path specified in recommendation 1, the Congress should direct theSecretary to increase the shared savings opportunity for physicians and health professionalswho join or lead two-sided risk accountable care organizations (ACOs). The Secretary shouldcompute spending benchmarks for these ACOs using 2011 fee-schedule rates.	Delivery system reforms Physicians and other health professionals	October 2011
Enhancing Medicare’s technical assistance to and oversight of providers (1) The Congress should redesign the current Quality Improvement Organization program to allow the Secretary to provide funding for time-limited technical assistance directly to providers and communities. The Congress should require the Secretary to develop an accountability structure to ensure these funds are used appropriately	Physicians and other health professionals	June 2011
Enhancing Medicare’s technical assistance to and oversight of providers (2) The Congress should authorize the Secretary to define criteria to qualify technical assistance agents so that a variety of entities can compete to assist providers and to provide community-level quality improvement. The Congress should remove requirements that the agents be physician sponsored, serve a specific state, and have regulatory responsibilities.	Physicians and other health professionals	June 2011
Enhancing Medicare’s technical assistance to and oversight of providers (3) The Secretary should make low-performing providers and community-level initiatives a high priority in allocating resources for technical assistance for quality improvement.	Physicians and other health professionals	June 2011
Enhancing Medicare’s technical assistance to and oversight of providers (4) The Secretary should regularly update the conditions of participation so that the requirements incorporate and emphasize evidence-based methods of improving quality of care.	Physicians and other health professionals	June 2011
Enhancing Medicare’s technical assistance to and oversight of providers (5) The Congress should require the Secretary to expand interventions that promote systemic remediation of quality problems for persistently low-performing providers.	Physicians and other health professionals Quality	June 2011