ADVI Analysis: MedPAC Meeting January 2023
Lindsay Bealor Greenleaf, JD, MBA
January 13, 2023
The Medicare Payment Advisory Commission (MedPAC) Public Meeting: January 12-13, 2023 Executive Summary
The MedPAC held its latest meeting on January 12-13, 2023 (link). The following relevant topics were discussed.
- Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; and supporting Medicare safety-net hospitals
- Assessing payment adequacy and updating payments: Physician and other health professional services; and supporting Medicare safety-net clinicians
- Assessing payment adequacy and updating payments: Outpatient dialysis services; hospice services; skilled nursing facility services; home health agency services; inpatient rehabilitation facility services
- The Medicare Advantage program: Status report
- Congressional request: Medicare clinician and outpatient behavioral health services
- Mandated report: Updates on telehealth use and beneficiary and clinician experiences
- Medicare Part D: Status report
- Addressing high prices of drugs covered under Medicare Part B
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The following are key takeaways from the January meeting.
- Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; and supporting Medicare safety-net hospitals
- MedPAC staff reviewed whether Medicare inpatient and outpatient payments to general acute care hospitals are adequate and how they should be updated in 2024 prior to their March 2023 Report to Congress.
- All commissioners voted in support of the Chairman’s draft recommendation
- Assessing payment adequacy and updating payments: Physician and other health professional services; and supporting Medicare safety-net clinicians
- MedPAC staff examined whether payments to physicians and other health professionals are adequate and how they should be updated in 2024. New Medicare safety-net add-on payment to support physicians and other clinicians who treat beneficiaries with low incomes was also considered.
- All commissioners voted in support of both of the Chairman’s draft recommendations
- Assessing payment adequacy and updating payments: Outpatient dialysis services; hospice services; skilled nursing facility services; home health agency services; inpatient rehabilitation facility services
- MedPAC staff reviewed whether payments for outpatient dialysis services, hospice providers, skilled nursing facilities, home health care services, and inpatient rehabilitation facilities (IRFs) are adequate and how they should be updated in 2024.
- All commissioners voted in support of all five of the Chairman’s draft recommendations
- The Medicare Advantage program: Status report
- MedPAC staff provided an update on the Medicare Advantage (MA) program. Commissioners reviewed staff findings and provided feedback on future work.
- There will be a chapter on this subject in the March 2023 Report to Congress
- Congressional request: Medicare clinician and outpatient behavioral health services
- MedPAC staff provided an overview of Medicare coverage of behavioral health services and reported on the utilization of clinician and outpatient- provided behavioral health services to Medicare beneficiaries, including tele- behavioral health services and utilization by enrollees in Medicare Advantage.
- This research is part of a Congressional request and will be included as an informational chapter in the June 2023 Report to Congress.
- Mandated report: Updates on telehealth use and beneficiary and clinician experiences
- MedPAC staff presented their research in response to a Congressional mandate to submit a report on the utilization of telehealth services during the Public Health Emergency (PHE) and the impact of expanded telehealth coverage on access to care and quality.
- The full chapter on telehealth will be in the June 2023 Report to Congress.
- Medicare Part D: Status report
- MedPAC staff presented their annual status report on the Part D program, including information about enrollment in 2022, plan offerings for 2023, and trends in indicators of program operations including drug pricing, aggregate spending levels, access, and quality. The material presented will be included in the March 2023 Report to Congress.
- MedPAC staff intend to continue an analysis of Direct and Indirect Renumeration (DIR) data in Spring 2023 (began in Fall 2022).
- Addressing high prices of drugs covered under Medicare Part B
- MedPAC staff reviewed and discussed three policy approaches to address the price of Part B drugs.
- A draft recommendation will be presented in MedPAC’s March session. The commissioners did not vote on any of the potential policy approaches during this session.
This is an abridged and delayed release. Full ADVI Analysis content is distributed in real time for retainer clients. Get in touch to learn more about how we can support your commercialization, market access, and policy needs.
Lindsay Bealor Greenleaf, JD, MBA
Senior Vice President, Market Access and Policy Strategy
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