MedPAC issues March report to Congress: 10 key Medicare issues

The Medicare Payment Advisory Commission has released its March 2015 report on Medicare payment policy to Congress, in which it makes fee-for-service payment rate recommendations and examines Medicare's payment rates for similar types of care that is often provided in different care settings.

Here are 10 key Medicare issues from MedPAC's March report.

1. MedPAC recommended Congress direct HHS to reduce or eliminate payment rate differences between outpatient departments and physicians offices for selected ambulatory services.

2. The commission recommended changes to long-term care hospital payment rates. MedPAC said long-term care hospital base payment rates for non-chronically critically ill cases should be the same as the base rates of acute-care hospitals. The changes should be phased in from 2016 to 2018, according to MedPAC.

3. The commission recommended the payment rates for the acute-care hospital inpatient and outpatient prospective payment systems be increased by 3.25 percent in 2016.

4. MedPAC called for the creation of a prospective per beneficiary payment to be established by Congress to replace the Primary Care Incentive Payment program after it expires in 2015.

5. The commission recommended Congress repeal the sustainable growth rate, and said the SGR should be replaced with a payment rate update that is higher for primary care services than for specialty services. MedPAC said the updated statutory fee-schedule updates should be implemented over a 10-year period.

6. Under the same 10-year path recommended for the statutory fee-schedule updates, MedPAC called for Congress to direct HHS to increase shared savings opportunities for physicians involved in accountable care organizations that include two-sided risk.

7. To establish more accurate values for work and practice expense, MedPAC recommended Congress direct HHS to regularly collect data from a "cohort of efficient practices rather than a sample of all practices." Using the data, MedPAC said HHS should identify overpriced fee-schedule services and reduce their relative value units accordingly.

8. MedPAC called for Congress to eliminate the update to the outpatient dialysis bundled payment rate for 2016.

9. The commission called for Congress to require ambulatory surgery centers to submit cost data.

10. MedPAC recommended Congress direct HHS to eliminate payment rate differences between inpatient rehabilitation facilities and skilled nursing facilities for selected conditions. The commission said the reductions should be phased in over a three-year period.

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