MedPAC Discusses Context for Medicare Payment Policy, CAHs, Rural Provider Quality

The Medicare Payment Advisory Commission (MedPAC) met on Sept. 5to discuss Medicare payment policy and rural health. The commissioners discussed the context for the Medicare payment policy chapter, which serves as a backdrop in their upcomingMarch report to Congress, reviewing Medicare spending trends, factors influencing projected spending, the financial status of Medicare's trust funds, beneficiary enrollment options, financial obligations, care disparities, and Medicare's role in the workforce. The commissioners also held a discussion emphasizing affordability, including additional considerations for Medigap plans to ensure access and quality.

In addition, the commissioners held a discussion on Medicare beneficiaries' cost-sharing for outpatient services at critical access hospitals (CAHs). The Medicare program provides CAHs with higher payment rates to support their financial viability, which are partially funded through higher beneficiary cost-sharing liabilities. To address this challenge, the commissioners discussed whether outpatient co-insurance calculations for care delivered at CAHs should be based on charges or payment rates and whether there should be a cap on co-insurance (similar to what exists under the current Outpatient Prospective Payment System).

In the final session of the day, commissioners discussed Medicare's measurement of rural provider quality and the challenges associated with rural quality reporting.