Medicare Payment Advisory Commission Recommends No Payment Increase for ASCs and Expresses Concerns about Quality Reporting in MIPS

This week, the Medicare Payment Advisory Commission (MedPAC) released its March 2017 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s analyses of payment adequacy in fee-for-service Medicare, and provides a review of Medicare Advantage (MA). The report also highlights the commission’s concerns with Medicare’s current clinician quality programs that will be used in the Merit-Based Incentive Payment System (MIPS).

MIPS

The report addresses the Commission’s repeated concerns with Medicare’s clinician quality programs and payment adjustments that will be used in MIPS. “First, the quality reporting requirements are confusing and burdensome to providers, and the link between performance and the resulting payment adjustment is unclear. Second, the quality reporting process does not allow creation of a national performance benchmark across the entire universe of clinicians. Third, many of the quality measures are not linked to outcomes of importance for the beneficiary. And forth, the measures do not generally assess low-value.”

ASC Payment

MedPAC recommends no payment increase for 2018 for three FFS payment systems: ambulatory surgical centers, long-term care hospitals, and hospice. MedPAC continues to make recommendations to ensure high-quality care for Medicare beneficiaries at lower costs to the program and recommends that payments be increased by the amount specified in current law for physicians and other health professionals. In addition, MedPAC recommends that Congress should also require ambulatory surgical centers to submit cost data.

MA Update

According to the report, in 2016, MA enrollment increased by 5% to 17.5 million beneficiaries. MedPAC discussed that MA benchmarks are currently based on the Medicare spending of all FFS beneficiaries and results in a disconnect between the enrollment status of people in MA and the status of the beneficiaries used to calculate the MA benchmarks. Therefore, MedPAC recommends that the secretary should calculate MA benchmarks using FFS spending data only for beneficiaries enrolled in both Part A and Part B. This would ensure equity between FFS and the MA program, and equity across MA plans.