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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
Promoting the use of primary care (A) The Congress should establish a budget-neutral payment adjustment for primary care services billed under the physician fee schedule and furnished by primary-care-focused practitioners. Primary-care-focused practitioners are those whose specialty designation is defined as primary care and/or those whose pattern of claims meets a minimum threshold of furnishing primary case services. The Secretary would use rulemaking… Read more »	Delivery system reforms Physicians and other health professionals	June 2008
Promoting the use of primary care (B) The Congress should initiate a medical home pilot project in Medicare. Eligible medical homes must meet stringent criteria, including at least the following capabilities: * Furnish primary care (including coordinating appropriate preventive, maintenance, and acute health services), * Conduct care management, * Use health information technology for active clinical decision support, * Have a formal… Read more »	Physicians and other health professionals Quality	June 2008
Home health services The Congress should eliminate the update to payment rates for home health care services for calendar year 2009.	Post-acute care	February 2008
Hospital inpatient and outpatient services (1) The Congress should increase payment rates for the acute inpatient and outpatient prospective payment systems in 2009 by the projected rate of increase in the hospital market basket index, concurrent with implementation of a quality incentive payment program.	Hospital Quality	February 2008
Hospital inpatient and outpatient services (2) The Congress should reduce the indirect medical education adjustment in 2009 by 1 percentage point to 4.5 percent per 10 percent increment in the resident-to-bed ratio. The funds obtained by reducing the indirect medical education adjustment should be used to fund a quality incentive payment program.	Hospital Quality	February 2008
Increasing participation in the Medicare Savings Programs and the low-income drug subsidy (1) The Secretary should increase the State Health Insurance Assistance Program funding for outreach to low-income Medicare beneficiaries.	Beneficiaries and coverage Drugs, Devices, and Tests	February 2008
Increasing participation in the Medicare Savings Programs and the low-income drug subsidy (2) The Congress should raise Medicare Savings Program income and asset criteria to conform to low-income drug subsidy criteria.	Beneficiaries and coverage Drugs, Devices, and Tests	February 2008
Increasing participation in the Medicare Savings Programs and the low-income drug subsidy (3) The Congress should change program requirements so that the Social Security Administration screens low-income drug subsidy applicants for federal Medicare Savings Program eligibility and enrolls them if they qualify.	Beneficiaries and coverage Drugs, Devices, and Tests	February 2008
Inpatient rehabilitation facility services The update to the payment rates for inpatient rehabilitation facility services should be eliminated for fiscal year 2009.	Post-acute care	February 2008
Long-term care hospital services The Secretary should update payment rates for long-term care hospitals for rate year 2009 by the projected rate of increase in the rehabilitation, psychiatric, and long-term care hospital market basket index less the Commission’s adjustment for productivity growth.	Post-acute care	February 2008