The Medicare Payment Advisory Commission (MedPAC), a non-partisan, independent legislative branch commission created to advise Congress about Medicare-related issues, met virtually March 3–4 to discuss the findings of its 21 virtual focus groups. The groups identified emerging trends not discernable through traditional claims data (e.g., telehealth) and delays in care due to the COVID-19 public health emergency.
During the meeting, the groups provided qualitative descriptions of beneficiary and clinician experience across topics, including access to care, Medicare coverage options and prescription drugs. They also made suggestions for MedPAC to consider for future focus groups, such as ensuring the selection of participants from underserved communities, minorities and lower socioeconomic groups.
MedPAC also discussed ways to combat current challenges presented by the Centers for Medicare and Medicaid Services (CMS) related to the agency’s alternative payment model (APMs) portfolio. In MedPAC’s June 2021 report to Congress, the commission recommended CMS implement a more harmonized portfolio of fewer APMs that are designed to work compatibly.
The final session of the meeting focused on improving risk adjustment calculations for Medicare Advantage (MA) plans. The current methodology can generate payment inaccuracies due to the inclusion of outlier beneficiaries (patients whose annual Medicare costs are very high or very low). Last fall, MedPAC started exploring a new approach to these risk-based calculations.