Medicare Payment Advisory Commission Launches Meeting Cycle with Full Docket
The Medicare Payment Advisory Commission (MedPAC) began their 2020 – 2021 meeting cycle virtually in September, and focused primarily on the impact of COVID-19 on the Medicare program, the ongoing transition to value-based care, rural health care issues and telehealth expansion. It is likely that discussion of these issues will continue throughout the remainder of the meeting cycle. In addition, a discussion of payment update recommendations will be included in the December meeting. The following highlights are from the September, October and November MedPAC meetings.
Remy Kerr, MPH, AMRPA Health Policy and Research Manager
September – The Coronavirus Pandemic and Medicare, Context for Medicare Payment Policy and Expansion of Telehealth in Medicare MedPAC initiated their 2020 – 2021 meeting cycle on Sept. 3 by addressing the profound effect the COVID-19 public health emergency (PHE) has on the Medicare program, Medicare insolvency projections, and permanent expansion of telehealth in Medicare. The Coronavirus Pandemic and Medicare session addressed the impact of COVID-19 on Medicare from beneficiary and provider standpoints. MedPAC reported that 80% of COVID-19 deaths are among ages 65 and older, with 40% among nursing home and assisted living residents. COVID-19 impacts beneficiary access to care and utilization, with many delaying or foregoing care due to fear of infection or because of temporary provider closures. The overall effect on patient outcomes is yet unknown. For provider impact, MedPAC shared an overview of: (1) volume changes during Q2 2020 for acute and post-acute care providers; (2) acute hospital margins and the impact of PHErelated policy changes; and (3) CARES Act funding distributions, based on an unnamed sample of non- and for-profit acute care hospital systems. Much discussion focused on the need for greater data on disbursement of relief funds in COVID-19 impacted areas. Commissioners expressed specific concerns with how Medicare funds are dispersed, and with the number of COVID-19 Medicare patients who receive treatment at funded hospitals. There was agreement that the impact of COVID-19 on utilization and margins across settings be considered when making future payment update recommendations. The Context for Medicare Payment Policy session focused on the outlook for the Medicare Trust Fund and recommendations to prevent insolvency. Estimates show Medicare spending doubling within the next decade, with the Hospital Insurance Trust Fund (Part A) projected to be insolvent by 2026. However, the Congressional Budget Office projects that Part A will be insolvent by 2024 due to COVID-19. MedPAC provided data related to Medicare Advantage (Part C), and reported that spending per beneficiary in Medicare Advantage is growing faster than original Medicare or
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