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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
Hospital inpatient and outpatient services (1) The Congress should increase payment rates for the acute inpatient and outpatient prospective payment systems in 2011 by the projected rate of increase in the hospital market basket index, concurrent with implementation of a quality incentive payment program.	Hospital Quality	March 2010
Hospital inpatient and outpatient services (2) To restore budget neutrality, the Congress should require the Secretary to fully offset increases in inpatient payments due to hospitals’ documentation and coding improvements. To accomplish this goal, the Secretary must reduce payment rates in the inpatient prospective payment system by the same percentage (not to exceed 2 percentage points) each year in 2011, 2012,… Read more »	Hospital	March 2010
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
Public reporting of physicians’ financial relationships (4) The Congress should require all hospitals and other entities that bill Medicare for services to annually report the ownership share of each physician who directly or indirectly owns an interest in the entity (excluding publicly traded corporations). The Secretary should post this information on a searchable public website.	Hospital Physicians and other health professionals	February 2009
Public reporting of physicians’ financial relationships (5) The Congress should require the Secretary to submit a report, based on the Disclosure of Financial Relationships Report, on the types and prevalence of financial arrangements between hospitals and physicians.	Hospital Physicians and other health professionals	February 2009
A path to bundled payment around a hospitalization (A) The Congress should require the Secretary to confidentially report readmission rates and resource use around hospitalization episodes to hospitals and physicians. Beginning in the third year, providers’ relative resource use should be publicly disclosed.	Hospital Physicians and other health professionals	June 2008
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
A path to bundled payment around a hospitalization (C) The Congress should require the Secretary to create a voluntary pilot program to test the feasibility of actual bundled payment for services around hospitalization episodes for select conditions. The pilot must have clear and explicit thresholds for determining whether it can be expanded into the full Medicare program or should be discontinued.	Delivery system reforms Hospital	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