September 09, 2020

MedPAC Discusses Medicare Trust Fund, COVID-19 and Telehealth Expansion

On Sept. 3 and 4, American College of Radiology® staff attended the Medicare Payment Advisory Commission (MedPAC) virtual September meeting. Topics discussed included COVID-19 and Medicare, the solvency of the Medicare trust fund and the expansion of telehealth in Medicare.

MedPAC staff presented on the COVID-19 pandemic and its effects on Medicare beneficiaries, and the finances of hospitals, post-acute care providers and clinicians. Research found that 80% of COVID-19 deaths have been in the 65+ population, and over 40% of deaths have been among residents of nursing homes and assisted living facilities. There was a significant decline in hospital volume in April, followed by a rebound in May and June. MedPAC staff stated that federal grants, loans and payment increases have likely offset a majority, but not all, of clinicians’ losses in the short term.

MedPAC staff also presented on the status of Medicare spending. Staff research shows that Medicare spending is projected to nearly double in the next 10 years, and that the Medicare trust fund may become insolvent as soon as 2024 due to COVID-19, when previously projected for insolvency in 2026. Commissioners stressed the urgency of the situation and the need to be bold in reaching potential solutions.

Staff re-introduced the telehealth expansion discussion, as it has been previously examined by the commission but brought to the forefront with the COVID-19 public health emergency (PHE) and broad utilization. Commissioners were generally supportive of telehealth expansion, however, varied in degrees of enthusiasm as to which policies they believe should stay after the PHE, with some commissioners wary of the potential impacts on Medicare spending and health disparities. MedPAC staff presented a potential policy option of allowing most telehealth expansions, under the policies set in place under the PHE, to providers in advanced alternative payment models, as they already assume financial risk. This potential policy would allow some telehealth expansions to providers in traditional fee-for-service, but with additional safeguards implemented.

The Commission will meet next Oct. 1 and 2. Learn more and access meeting materials online.