MedPAC Report Addresses Synchronizing Medicare Policy Across Payment Models


The Medicare Payment Advisory Commission (MedPAC) recently released its biannual report to Congress.  In the report, MedPAC addresses synchronizing Medicare policy across payment models.  Historically, there have been two payment models: (1) Medicare fee-for-service, and (2) Medicare Advantage.  Starting in 2012, however, Medicare introduced a third payment model: the Accountable Care Organization (ACO).  In the report, MedPAC explains that a “major issue is that Medicare’s payment rules and quality improvement incentives are different and inconsistent across the three payment models.”  Accordingly, MedPAC “is examining synchronizing policy across payment models with respect to spending benchmarks, quality measurement, and risk adjustment and will be examining synchronizing regulatory oversight.”

In the report, MedPAC also examines the following issues:  

  • improving risk adjustment in the Medicare program;
  • reevaluating current approaches to measuring the quality of care in Medicare;
  • aligning financial assistance policies for low-income beneficiaries;
  • paying for primary care using a per beneficiary payment;
  • addressing Medicare payment differences across post-acute settings; and
  • measuring the effects of medication adherence on medical spending for the Medicare population.

The MedPAC report is available here.

Reporter, Stephanie Johnson, Atlanta, +1 404 572 4629,

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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