The Medicare Payment Advisory Commission (MedPAC) meets January 13-14 to discuss and vote on the basic payment rates for hospital services for inpatients and outpatients, as well as the Commission’s draft recommendations for renewing physician payments. And discussed the mandatory reports on the design. Above all, the Acute Post-Acute Value Incentive Program (VIP).
Hospital payment renewal
MedPAC staff will provide up-to-date information on the adequacy of inpatient and outpatient hospital service payments discussed at previous meetings, with access to beneficiary care, quality, access to hospital capital, and hospitals. Presented across four key indicators of Medicare payments compared to the cost of. [refer to Washington Highlights, Dec. 10, 2021].. Using the latest available data (since 2020), staff reiterated that the relevance of payments across these indicators is generally positive. However, staff said that since the December renewal of MedPAC, Congress has extended the 2% Medicare quarantine suspension until March 31, 2022, and the Department of Health and Human Services has paid $ 9 billion in Provider Relief Fund Phase 4 payments. He said he had started distribution. Still, MedPAC’s projected 2022 Medicare margin has not changed (-10% for inpatients’ future payment system hospitals).
For both inpatient and outpatient payments, Commission staff did not anticipate long-term changes that would affect the adequacy of payments beyond the COVID-19 Public Health Emergency (PHE). I reconfirmed that. Staff argued that the impact of volatile COVID-19 is best addressed through targeted temporary funding policies rather than changing basic payment rates.
The Commissioner unanimously voted to approve the proposed recommendations for inclusion in MedPAC’s March 2022 report. 2% update. The commissioner unanimously endorsed the proposed recommendations, but the need to monitor ongoing supply chain and staffing issues that could affect payment adequacy and survive beyond the end of PHE, etc. , Repeated some concerns. In addition, the Commissioner was concerned that these issues might not be adequately reflected in the 2023 market basket update that the Commission monitors throughout the year.
Renewal of doctor’s payment
A draft recommendation for updating payment rates for physician and other health care professional services in 2023 was also discussed and voted on at a two-day meeting. MedPAC assesses the adequacy of Medicare physicians’ payments by examining data in three areas: access to care, the quality of care that clinicians provide to beneficiaries, and clinician revenue and cost.
The Commission found that most patients reported access to private insurance and comparable care to the previous year, and that the number of clinicians claiming Medicare was stable. The number of clinician encounters per beneficiary decreased in 2020. However, MedPAC attributed this decline to the ongoing PHE. Regarding the quality of care, the Commission noted that the patient’s experience score remained high. However, the 2020 quality indicators are difficult to interpret due to the unique challenges posed by the pandemic. Medicare staff said Medicare payments to clinicians fell by $ 9 billion between 2019 and 2020, but clinicians helped billions of dollars to offset the economic loss of a pandemic. I received help.
Based on this information, in a unanimous vote, MedPAC approved the recommendations to be included in the March 2022 report. Increased by 0% in the calendar year of 2023. The Commission does not expect its recommendations to affect beneficiary access to care or the willingness and ability of clinicians to provide care. However, the MedPAC Commissioner expressed concern about the impact of inflation on physician well-being and physician practice.
Post-Acute Care (PAC) Value Incentive Program (VIP)
MedPAC staff presented the findings of a mandatory report on the design of value-based purchasing programs under the potential of a future unified PAC future payment system (PPS). Congress mandated this report as part of the 2021 Integrated Expenditure Act (CAA, PL116-260). The next March 2022 report to Congress will include the chapter.
The PAC VIP contains five key design elements. (1) a small set of performance measurements, (2) strategies to ensure reliable results, (3) a system that distributes rewards with minimal “cliff” effects, (4) patient health-related social needs Explain the difference, and (5) how to distribute a pool of dollars funded by the provider. MedPAC staff have included an example model of each design element in the presentation for the commissioner to consider.
After the implementation of the conceptually unified PAC PPS is complete, the commissioner is interested in further assessment of another approach to explain health-related social needs in broader risk coordination as the final step in PAC VIP. I did. This addresses the challenges presented by MedPAC staff, who emphasize the various empirical implications for quality performance with PAC settings that use the same peer grouping approach to account for social risks.
