MedPAC Discusses Financial Impacts, Medicare Advantage, Acute Care Hospital at Home

The Medicare Payment Advisory Commission (MedPAC) met Sept. 7 and 8 to discuss a variety of policy issues, including financial impacts on the Medicare program, Medicare Advantage plans, and the Acute Care Hospital at Home program.

The commission set the stage for this cycle on Thursday with a discussion of the financial impacts on the Medicare program. This discussion mainly focused on recent spending trends, factors influencing Medicare’s future spending, an update on the financial status of Medicare’s trust fund, and the affordability of Medicare beneficiaries’ premiums and cost sharing.

The Thursday afternoon sessions focused on Medicare Advantage (MA), where commission staff foreshadowed that five chapters of the March and June 2024 Reports to Congress will be dedicated to MA topics. The annual MA Status Report will include methods for estimating coding intensity and favorable beneficiary selection in estimates of payments to MA plans. In upcoming meetings in the 2023-24 cycle, MedPAC will discuss a new framework for evaluating MA plan quality and access performance, including the use of traditional clinical quality metrics and new metrics of network adequacy and use of prior authorization, in addition to new analytic projects on network design and ambulatory care-sensitive hospitalizations at the local MA market level. Commissioners intend to better assess the completeness and accuracy of MA encounter data submitted to the Centers for Medicare & Medicaid Services and compare utilization data submitted in plans’ bids versus the encounter data. Finally, commissioners potential advantages of standardizing policy benefits in MA plans to inform future work.

During the Friday morning session, MedPAC explored the Medicare Acute Care Hospital at Home program, focusing on its development and characteristics, as well as its utilization and challenges. The commission also noted that there will be a chapter on this topic included in their report, but they will not be including recommendations at this time.  Lastly, the commission held a primer on ambulatory surgical centers (ASC), which included some discussion on the movement of services from hospital outpatient departments to ASCs and the related challenges.