As required by the Congress, each March the Medicare Payment Advisory Commission reviews and makes recommendations for Medicare fee-for-service (FFS) payment systems and the Medicare Advantage (MA) program. In this report, we:

• Consider the context of the Medicare program in terms of its spending and the federal budget and national gross domestic product.
• Consider Medicare FFS payment policy in 2011 for: hospital inpatient, hospital outpatient, physician, ambulatory surgical center, outpatient dialysis, hospice, skilled nursing, home health, inpatient rehabilitation, and long-term care hospital.
• Discuss the status of the MA plans beneficiaries can join in lieu of traditional FFS Medicare and reiterate prior year payment recommendations.
• Review the status of the plans that provide prescription drug coverage.
• Respond to a congressional mandate to examine how to compare quality among MA plans and between those plans and traditional Medicare.

The goal of Medicare payment policy is to get good value for the program's expenditures, which means maintaining beneficiaries' access to high-quality services while encouraging efficient use of resources. Anything less does not serve the interests of the taxpayers and beneficiaries who finance Medicare through their taxes and premiums. Although this report addresses many topics to increase value, its principal focus is the Commission's recommendations for annual rate increases (updates) under Medicare's various FFS payment systems. ...

Download: Report to the Congress: Medicare Payment Policy (March 2010)

PDF format, 6.3MB, 381Pages.

Medicare Payment Advisory Commission
601 New Jersey Avenue, NW • Suite 9000 • Washington, DC 20001
(202) 220-3700 • Fax: (202) 220-3759 • www.medpac.gov

The report contains six chapters:

• a chapter that provides context for those that follow by documenting the rise in Medicare and total health care spending.
• a chapter with five sections that describes the Commission’s recommendations on rate updates for six payment systems used by traditional Medicare.
• a chapter with four sections that describes the Commission’s recommendations on rate updates for the four post acute care payment systems used by traditional Medicare.
• a chapter that provides updated statistics on enrollment, plan offerings, and payments in Medicare Advantage plans and repeats our recommendations from previous years.
• a chapter with updated statistics on enrollment and plan offerings for plans that provide prescription drug coverage.
• a chapter responding to a congressional mandate to compare quality among Medicare Advantage plans and between those plans and traditional Medicare, with the Commission’s recommendations.

The goal of Medicare payment policy is to get good value for the program’s expenditures, which means maintaining beneficiaries’ access to high-quality services while encouraging efficient use of resources. Anything less does not serve the interests of the taxpayers and beneficiaries who finance Medicare through their taxes and premiums. ...

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