On June 15, the Medicare Payment Advisory Commission (MedPAC) released its annual report to Congress. Each year, as part of its statutory mandate, MedPAC reports on issues affecting the Medicare program, as well as changes in the health care delivery system more broadly. A press release is available here. Matters of interest to neurosurgery in the report include:
- Acknowledgement of physician concerns about increasing practice costs and decreasing payment under the Medicare Physician Fee Schedule (MPFS). The report notes, “This gap between the growth in clinician input costs and updates to MPFS payment rates could, over time, create incentives for clinicians to reduce the number of Medicare beneficiaries they treat or stop participating in Medicare entirely.”
- Two options to update MPFS payment rates based on some measure of inflation. The first approach would update the practice expense portion of the fee schedule payment rates by the hospital market basket, adjusted for productivity. The second approach would update total fee schedule payment rates by the Medicare Economic Index (MEI) minus one percentage point.
- A recognition that limited provider networks and inappropriately applied prior authorization requirements in Medicare Advantage programs have led to denial and delays of necessary patient care and contributed to provider administrative burden.
- A discussion of payment for software technologies in Medicare, suggesting continued evaluation and adjustment of payment models to accommodate the rapid advancement of medical software technologies. This includes considering the implications of Artificial Intelligence (AI) and machine skill learning, where software not only supports but potentially replaces human decision-making in clinical settings.
