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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
Accounting for new technology in hospital prospective payment systems (E) For the inpatient payment system, the Secretary should develop formalized procedures for expeditiously assigning codes, updating relative weights, and investigating the need for patient classification changes to recognize the costs of new and substantially improved technologies.	Delivery system reforms Hospital	March 2001
Developing input-price indexes for all health care settings To implement an occupation-mix adjusted wage index in fiscal year 2005, the Secretary should collect data on wage rates by occupation in the fiscal year 2002 Medicare cost reports. Hospital-specific wage rates for each occupation should be supplemented by data on the mix of occupations for each provider type. The Secretary also should continue to… Read more »	Hospital	March 2001
End-stage renal disease payment policies in traditional Medicare (A) The Congress should instruct the Secretary to broaden the composite rate payment bundle to include widely used services currently excluded from it. The Secretary should continue to emphasize quality monitoring and quality improvement efforts to ensure that patients have access to high-quality dialysis care.	Ambulatory care settings	March 2001
End-stage renal disease payment policies in traditional Medicare (B) The Congress should instruct the Secretary to evaluate whether the composite rate’s unit of payment- a single dialysis session- should be revised to reflect better the way dialysis is furnished.	Ambulatory care settings	March 2001
End-stage renal disease payment policies in traditional Medicare (C) The Congress should instruct the Secretary to revise the outpatient dialysis payment system to account for factors that affect providers’ costs to deliver high-quality clinical care, including dialysis method, dose, frequency, and patient activity.	Ambulatory care settings	March 2001
End-stage renal disease payment policies in traditional Medicare (D) The Congress should instruct the Secretary to develop a wage index based on market wage rates for occupations typically used in furnishing dialysis.	Ambulatory care settings	March 2001
End-stage renal disease payment policies in traditional Medicare (E) For calendar year 2002, the composite rate for outpatient dialysis services should remain unchanged.	Ambulatory care settings	March 2001
Financial performance and inpatient payment issues for PPS hospitals (A) The inpatient PPS operating update of market basket minus 0.55 percent set in law for fiscal year 2002 will provide a reasonable level of payments.	Hospital	March 2001
Financial performance and inpatient payment issues for PPS hospitals (B) In collecting sample patient-level data, HCFA should seek to balance the goals of minimizing payment errors and furthering understanding of the effects of coding on case-mix change.	Hospital	March 2001
Financial performance and inpatient payment issues for PPS hospitals (C) Although the Benefits Improvement and Protection Act of 2000 improved the equity of the hospital disproportionate share adjustment, Congress still needs to reform this adjustment by: * Including the costs of all poor patients in calculating low-income shares used to distribute disproportionate share payments, and * Using the same formula to distribute payments to all… Read more »	Hospital	March 2001