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Archive for MedPAC


Low Participation Plagues Dual-Eligibles Demo

A federal demonstration program that seeks to improve care for those eligible for both Medicare and Medicaid is suffering from under-participation. This perspective was presented during last week’s meeting of the Medicare Payment Advisory Commission, the independent federal agency that advises Congress on Medicare payment and policy issues. Among the factors affecting participation have been difficulties identifying eligible participants, resistance from providers, and low provider payments. Because of the low participation, it has been difficult to measure the program’s effectiveness in better coordinating patients’ care. Currently 61 health plans in 12 states participate in the program. Such programs are important [&hellip

MedPAC Addresses Issues at April Meeting

Last week the Medicare Payment Advisory Commission met in Washington, D.C. On its agenda were the following issues on which MedPAC is advising Congress: the development of a unified prospective payment system for post-acute care improving Medicare Part D Medicare Part B drug and oncology payment policy issues using encounter data for risk adjustment in Medicare Advantage hospice and Medicare spending measuring low-value care preserving access to emergency care in rural areas CMS’s financial alignment demonstration for dual-eligible beneficiaries Go here to find the issue briefs and presentations used during the two-day meeting

New Approaches to Readmissions Reduction Program?

While Medicare’s readmissions reduction program has produced a decline in the number of Medicare readmissions within 30 days of discharge, critics – among them the National Association of Urban Hospitals – argue that the program is unfair to hospitals that serve especially large numbers of low-income patients whose distinct needs pose a greater risk of requiring readmission to address. In a new report, the journal Health Affairs notes that such arguments have given rise to a number of proposals for possible changes in the readmissions reduction program. Among them, the Medicare Payment Advisory Commission …has proposed a revision to the [&hellip

MedPAC Offers DSH, 340B Recommendations

The Medicare Payment Advisory Commission has recommended that Congress direct changes in the 340B prescription drug discount program and in the manner in which Medicare makes disproportionate share hospital payments (Medicare DSH). In its annual report to Congress, MedPAC recommended a reduction in 340B prescription drug payments to hospitals. The proposed reduction would cut 340B program spending approximately $300 million. MedPAC then recommended that those 340B savings be redirected to the Medicare DSH uncompensated care pool. And it also called for distributing the money in that pool based on better data on the uncompensated care hospitals provide, as reported on [&hellip

MedPAC Meets, Considers Issues

Members of the Medicare Payment Advisory Commission (MedPAC) met last week in Washington, D.C. to discuss policies and potential recommendations to Congress on a number of Medicare payment issues. Among the issues on the agenda were: developing a unified payment system for post-acute care telehealth services improving Medicare Part D Part B drug payment policies improving the efficiency of oncology care in the Medicare fee-for-service program using competitive pricing to set beneficiary premiums in the Medicare Advantage and Medicare fee-for-service programs MedPAC is an independent agency that recommends Medicare payment policies to Congress. Its recommendations are not binding but are [&hellip

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