MedPAC wants Congress to increase hospitals and clinicians' 2024 Medicare payment rates.
Commissioners hashed out draft payment recommendations for providers in a marathon two-day meeting last week.The advisory agency looks poised to recommend that Congress increase Medicare payment to hospitals by 1% over what the law prescribes.
Commissioners generally support asking Congress to give an extra increase to safety-net hospitals on top of that. MedPAC is also likely to recommend a pay boost for clinicians paid through the physician fee schedule and larger increases for providers caring for low-income traditional Medicare patients. MedPAC doesn't often recommend pay increases for hospitals or clinicians. Rising costs factored into the 2024 draft recommendations, staff said during the meeting. But increasing Medicare payments requires new Medicare spending. That's a tough sell in Congress as the Medicare Part A trust fundSkilled nursing facilities face a less rosy outlook. MedPAC's draft recommendation asks Congress to cut Medicare base payments for SNFs by 3% in 2024, relative to 2023 rates. Commissioners acknowledged that the nursing home industry has been through a tough couple of years. But they largely supported the recommendation, given MedPAC's mandate to examine access to care, quality of care, availability of capital and provider costs in the sector. "We are certainly not signaling that the sector is healthy long term," MedPAC chair Michael Chernew said during the meeting. "We are doing a much more prescribed exercise that we do across the board."MedPAC also discussed Medicare payment recommendations for other provider types at the meeting.Congress should decrease base pay by 3%.Congress should update base pay by current law, which amounts to a roughly 1.5% increase.Congress should update base pay by current law, but also wage-adjust the aggregate cap each hospice provider can receive and reduce it by 20%.MedPAC will vote on the recommendations in January after staff makes some changes based on commissioner feedback. MedPAC will then submit official recommendations to Congress in March. "We try and make the best recommendations we can," Chernew said during Thursday's MedPAC session. "Will [Congress] do it? There's a lot of issues that they face, and I'm not going to hesitate to speculate on how this would all play out."
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