The Medicare Payment Advisory Commission (MedPAC) met virtually March 2–3, to discuss payment policy topics in preparation for its March report to Congress. MedPAC is a non-partisan, independent legislative branch commission created to advise Congress about Medicare-related issues.
Commissioners discussed a draft recommendation to Congress to repeal the existing Medicare wage index statuses, including current exceptions. They recommend requiring the secretary of the U.S. Department of Health and Human Services to phase in new systems that:
- Use all employer, occupation-level wage data with different occupation weights for each provider.
- Reflect local area level differences in wages between and within metropolitan and rural areas, and smooth wage index differences across local adjacent areas.
Commissioners showed support for this updated, more general recommendation about how wage indices should be reformed.
Favorable selection and future directions for Medicare Advantage (MA) payment policy were also discussed. Commissioners outlined three alternative options to replace and improve the current methodology of setting MA benchmarks in an effort to promote competitive bidding.
MedPAC continued its work to align fee-for-service payment rates across three ambulatory settings for selected services to closely match the payment rate of the lowest cost setting without adversely affecting beneficiaries’ access to care and without changing aggregate outpatient prospective payment systems (OPPS) spending. While some commissioners showed support for the draft recommendation to align rates for 66 of the 169 ambulatory payment classification categories, concerns were also raised due to rural hospitals receiving a 2.5% reduction in Medicare payments and government hospital payments reduced by 0.8% under this recommendation.