The Medicare Payment Advisory Commission (MedPAC) met virtually April 7–8 to discuss several payment policy topics in preparation for its June report to Congress. MedPAC is a non-partisan, independent legislative branch commission created to advise Congress about Medicare-related issues.
The commissioners discussed social determinants of health (SDOH) and proposed ways to leverage Medicare policies to address disparities caused by social risk factors. Many organizations in the public and private sectors are prioritizing SDOH for measuring quality improvement, which aligns with CMS’ push for advancing health equity across programs such as quality reporting and innovation models. The commissioners cautioned that while strong incentives for achieving value are critical, it is important to apply these incentives fairly. MedPAC has started analytic work examining safety-net providers who predominantly care for beneficiaries with SDOH to guide Medicare in reducing their financial strain. There was a call for CMS to improve and broaden data collection so that SDOH can be deliberately included in MedPAC’s payment adequacy analyses.
MedPAC commissioners also discussed the potential consolidation of Medicare’s alternative payment models (APMs). Commissioners favor reducing the number of APMs into fewer groupings based on size of participating organization. They proposed ways to modify the performance benchmarks to account for SDOH and incentivize providers to participate in APMs.
The final session of the meeting focused on aligning varied fee-for-service payment rates across ambulatory settings, with the goal of reducing beneficiary cost sharing. The commissioners also debated the best use for the hospitals’ savings from aligning payment rates: whether to keep budget neutrality, use all of it as savings or temporarily support safety-net providers.