The Medicare Payment Advisory Commission held its most recent meeting last week. Here are four major items discussed from its agenda.
1. Geographic payment adjustments and the physician fee schedule. MedPAC was mandated to study the effects of Medicare geographic payment adjustments for physicians, which would essentially allow for greater physician compensation to those who practice in rural settings where access to care is generally not as frequent. MedPAC recommended there be no changes to the current law on geographic payment adjustments. It also said a geographic adjustment for professional work must involve heavy data collection and should consider alternative measures such as the cost-of-living index and hospital wage index.
2. Medicare payment for outpatient therapy services. The Middle Class Tax Relief and Job Creation Act of 2012 — also known as last year's payroll tax cut bill — required MedPAC to look at ways to reform outpatient therapy services payments under Medicare Part B, with a final report due in June 2013. MedPAC made draft recommendations to assure Medicare's integrity of outpatient therapy services and to improve the long-term condition of the payment system.
3. Potentially preventable admissions and emergency department visits. A MedPAC study found that roughly 25 percent of all initial hospital admissions are potentially preventable and unnecessary, and 59 percent of all ambulatory ED visits are preventable. Consequently, MedPAC said there needs to be further research on how access to ambulatory care impacts these types of preventable admissions and visits.
4. Medicare payments for ambulance services. In June 2013, MedPAC must issue a report on the appropriateness and effect of ambulance add-on payments for providers. The commission issued several initial findings, including that nonemergency transports are growing rapidly, particularly for dialysis-related patients, and these nonemergency transports may be incorrectly valued in the current Medicare fee schedule.
1. Geographic payment adjustments and the physician fee schedule. MedPAC was mandated to study the effects of Medicare geographic payment adjustments for physicians, which would essentially allow for greater physician compensation to those who practice in rural settings where access to care is generally not as frequent. MedPAC recommended there be no changes to the current law on geographic payment adjustments. It also said a geographic adjustment for professional work must involve heavy data collection and should consider alternative measures such as the cost-of-living index and hospital wage index.2. Medicare payment for outpatient therapy services. The Middle Class Tax Relief and Job Creation Act of 2012 — also known as last year's payroll tax cut bill — required MedPAC to look at ways to reform outpatient therapy services payments under Medicare Part B, with a final report due in June 2013. MedPAC made draft recommendations to assure Medicare's integrity of outpatient therapy services and to improve the long-term condition of the payment system.
3. Potentially preventable admissions and emergency department visits. A MedPAC study found that roughly 25 percent of all initial hospital admissions are potentially preventable and unnecessary, and 59 percent of all ambulatory ED visits are preventable. Consequently, MedPAC said there needs to be further research on how access to ambulatory care impacts these types of preventable admissions and visits.
4. Medicare payments for ambulance services. In June 2013, MedPAC must issue a report on the appropriateness and effect of ambulance add-on payments for providers. The commission issued several initial findings, including that nonemergency transports are growing rapidly, particularly for dialysis-related patients, and these nonemergency transports may be incorrectly valued in the current Medicare fee schedule.
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