Insights,

ADVI Analysis: MedPAC January 2024 Meeting

MedPAC held a meeting January 11-12, 2024 (link). The following relevant topics were discussed:

  • Assessing payment adequacy and updating payments: Physician and other health professional services
  • Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services
  • Medicare Part D: Status report
  • The Medicare Advantage program: Status report
  • Standardizing benefits in Medicare Advantage plans

ADVI Angle

Key takeaways from the January meeting include:

  • Assessing payment adequacy and updating payments: Physician and other health professional services
    • Commissioners reviewed draft recommendations to increase the physician fee schedule rate by half of the Medicare Economic Index and add add-on payments for low-income beneficiaries. Commissioners unanimously voted in favor of the draft recommendations.
  • Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services
    • Commissioners largely agreed with the draft recommendations to increase fees to hospitals for services. Some Commissioners grappled with grouping hospital inpatient and outpatient services and a number expressed the need for these funds to reach healthcare workers directly.
  • Medicare Part D: Status report
    • MedPAC staff reviewed Part D trends and expected changes.
    • Commissioners discussed and recommended additional Part D topics they believe should be included in the staff’s final Part D status report which will be sent to Congress in March.
  • The Medicare Advantage program: Status report
    • Commissioners reviewed and discussed the latest data on Medicare Advantage, including enrollment, market structure, and payments. Commissioners expressed concerns around the high cost and requested additional information on prior authorizations.
  • Standardizing benefits in Medicare Advantage plans
    • Staff provided multiple frameworks for standardizing benefits in Medicare Advantage plans. All Commissioners agreed that the current state was not consumer-friendly, and many Commissioners agreed with a framework that limited the number of plans per carrier.

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Anna Prokop

Manager