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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
Physician services (3) The Congress should update payments for physician services by 2.5 percent in 2003.	Physicians and other health professionals	March 2002
Skilled nursing facility services (1) The Secretary should develop a new classification system for care in skilled nursing facilities.	Post-acute care	March 2002
Skilled nursing facility services (2) If the Centers for Medicare & Medicaid Services refines the classification system for care in skilled nursing facilities, the temporary payment increase, previously implemented to allow time for refinement, will end. The Congress should retain this money in the base payment rate for skilled nursing facilities.	Post-acute care	March 2002
Skilled nursing facility services (3) For fiscal year 2003, the Congress should update payments to skilled nursing facilities as follows. For freestanding facilities, no update is necessary. For hospital-based facilities, update payments by market basket and increase payments by 10 percent until a new classification system is developed.	Post-acute care	March 2002
What next for Medicare+Choice? The Congress should set payments to Medicare+Choice plans at 100 percent of per capita local fee-for-service spending as soon as possible, and an adequate risk-adjustment mechanism should be phased in at least as rapidly as called for in current law.	Part C (Medicare Advantage)	March 2002
Assessing payment for outpatient hospital care in rural areas In the short term, no outpatient payment adjustments for rural hospitals are needed in addition to the current hold-harmless provision. The Secretary should revisit outpatient payments to rural hospitals when better information on hospitals’ experience with the payment system is available.	Hospital Regional issues	June 2001
Improving payment for inpatient hospital care in rural areas (A) The Congress should require that rural referral centers’ wages exceed the average wage in their area to quality for geographic reclassification, but these facilities should retain their waiver from the proximity rule.	Hospital Regional issues	June 2001
Improving payment for inpatient hospital care in rural areas (B) The Congress should require the Secretary to develop a graduated adjustment to the rates used in the inpatient prospective payment system for hospitals with low overall volumes of discharges. This adjustment should only apply to hospitals that are more than a specified number of miles from another facility providing inpatient care, with appropriate exceptions for… Read more »	Hospital Regional issues	June 2001
Improving payment for inpatient hospital care in rural areas (C) In fiscal year 2002, the Secretary should implement fully the policy of excluding from the hospital wage index salaries and hours for teaching physicians, residents, and certified registered nurse anesthetists.	Hospital	June 2001
Improving payment for inpatient hospital care in rural areas (D) To ensure accurate input-price adjustments in Medicare’s prospective payment systems, the Secretary should reevaluate current assumptions about the proportions of providers’ costs that reflect resources purchased in local and national markets.	Hospital	June 2001