The Medicare Payment Advisory Commission (MedPAC) met on April 1 and 2 to discuss a variety of policy issues, including recommendations to streamline the Centers for Medicare and Medicaid Services (CMS) portfolio of alternative payment models (APMs) and replace the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Program. MedPAC also discussed the current indirect medical education payment policy (see related story), separately payable drugs in the hospital outpatient prospective payment system, vaccine coverage and payment, Medicare Advantage benchmark policy, and a response to a Congressional request for information on the role of private equity in Medicare. The following recommendations will be included in MedPAC’s June 2021 Report to Congress.
CMS APM Portfolio
MedPAC commissioners unanimously voted to adopt a recommendation that the CMS should “implement a more harmonized portfolio of fewer alternative payment models that are designed to work together to support the strategic objectives of reducing spending and improving quality”. The commissioners stated that in the long run, their recommendation could result in significant benefits including improved care delivery, increased net savings for Medicare, increased incentives to manage care, improved performance on quality measures, reduced administrative burdens, and more predictable performance bonuses for providers [see Washington Highlights, March 5].
SNF VBP Program
MedPAC commissioners adopted a recommendation to replace the current SNF VBP Program with a new SNF Value Incentive Program (VIP), as previously discussed earlier this cycle [see Washington Highlights, March 5]. The recommended SNF VIP would be based on a small set of quality measures and use a peer grouping approach to stratify performance to account for differences in patient social risk factors. The commissioners also approved a second recommendation for Congress to direct the Department of Health and Human Services to develop and report patient experience measures for SNFs.