There are some reports every American should read regularly. One is the annual report to Congress from the Medicare Payment Advisory Commission. Medicare is in deep financial trouble. The report is used by the Commission to try to identify areas where the program can be improved, often from a financial perspective, but sometimes in regard to quality or access issues as well. Some of the highlights this year include the usual issues with high cost specialty drugs, which for Medicare often show up in Part B–the medical or outpatient benefits, meaning they hit consumers more directly, and with Part D–more routine drug benefits. The commission discussed the ongoing issues with Medicare Advantage plan reimbursement, including moving away from using fee-for-service spending as the comparator. Another very important topic is equalizing payment rates across outpatient settings for the same service, primarily so that hospital outpatient departments don’t continue to charge ridiculously high prices when the same service is much cheaper in a doctor’s office. Worth at least skimming through the report’s executive summary. (MedPAC Report)
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The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.
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MedPAC 2019 Report to Congress
June 18, 2019
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