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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
Report on comparing quality among Medicare Advantage plans and between Medicare Advantage and fee-for-service Medicare (7) The Secretary should develop and report on additional quality measures for Medicare Advantage plan and Medicare Advantage–to–fee-for-service comparisons that address gaps in current quality measures.	Part C (Medicare Advantage) Quality	March 2010
Home health services (3) The Congress should direct the Secretary to assess payment measures that protect the quality of care and ensure incentives for the efficient delivery of home health care. The study should include alternative payment strategies such as blended payments and risk corridors and outcome-based quality incentives.	Delivery system reforms Post-acute care Quality	February 2009
Hospital inpatient and outpatient services (1) The Congress should increase payment rates for the acute inpatient and outpatient prospective payment systems in 2010 by the projected rate of increase in the hospital market basket index, concurrent with implementation of a quality incentive payment program.	Hospital Quality	February 2009
Hospital inpatient and outpatient services (2) The Congress should reduce the indirect medical education adjustment in 2010 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 2009
A path to bundled payment around a hospitalization (B) To encourage providers to collaborate and better coordinate care, the Congress should direct the Secretary to reduce payments to hospitals with relatively high readmission rates for select conditions and also allow shared accountability between physicians and hospitals. The Congress should also direct the Secretary to report within two years on the feasibility of broader approaches,… Read more »	Delivery system reforms Hospital Physicians and other health professionals Quality	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
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
Outpatient dialysis services The Congress should update the composite rate in calendar year 2009 by the projected rate of increase in the end-stage renal disease market basket index less the Commission’s adjustment for productivity growth. The Commission reiterates its recommendation that the Congress implement a quality incentive program for physicians and facilities that treat dialysis patients.	Ambulatory care settings Physicians and other health professionals Quality	February 2008
Skilled nursing facility services (2) The Congress should establish a quality incentive payment policy for skilled nursing facilities in Medicare.	Delivery system reforms Post-acute care Quality	February 2008