Congressional Adviser
A mystery. That’s what MedPAC is to many hospitalists. You might recognize the name from communications about Medicare’s physician fee schedule, but what is this entity, what power does it possess, and how does it affect the work you do and the pay you receive?
MedPAC is the Medicare Payment Advisory Commission, an independent agency established by the Balanced Budget Act of 1997. Its mission is to advise Congress on issues affecting Medicare, including payments to private health plans participating in Medicare as well as providers in Medicare’s traditional fee-for-service program. MedPAC also analyzes and advises legislators on two issues on HM’s radar: access to care and quality of care.
HEALTH SPENDING OUTPACES GDP
Healthcare costs are on the rise, according to a CMS report that shows growth in national health expenditures (NHE) is expected to significantly outpace economic growth in 2008 and 2009 due to the recession. NHE is projected to grow 6.1% in 2008, as health spending increases from $2.2 trillion in 2007 to $2.4 trillion. Growth in the U.S. economy, as measured by the GDP, is anticipated at 3.5%. For 2009, health spending is projected to rise 5.5%, while the GDP is expected to decrease 0.2%. The health share of GDP is expected to increase to 16.6% in 2008 from 16.2% in 2007, and to 17.6% in 2009. Read more about the projections at www.cms.hhs.gov/NationalHealthExpendData/03_NationalHealthAccountsProjected.asp.
HHS LAUNCHES HEALTHCARE REFORM WEB SITE
A new HHS Web site (www.healthreform.gov) allows the public to view the White House Health Forum, find out about upcoming local health forums, read the Report on Health Care Community Discussions, and share thoughts about health reform with the administration.
Ear of the Law
Why is MedPAC important to hospitalists? Money. The commission advises Congress on how Medicare is going to pay for healthcare services, and Medicare is a major payor for any hospitalist, says Ron Greeno, MD, FHM, chief medical officer of Cogent Healthcare in Irvine, Calif., and a member of SHM’s Public Policy Committee. “The majority of patients we’ll be taking care of in any hospital are Medicare patients,” he says, “and it’s not just how we get paid, but all the regulations around that. … MedPAC will weigh in on that and certainly shape the thinking of lawmakers.”
“MedPAC is about payment … but obviously there are other policy issues they weigh in on,” Dr. Greeno says. For example, MedPAC makes specific recommendations on the physician fee schedule and determines how hospitalists document and code.
How It Works
The commission is made up of 17 volunteer members from a diverse spectrum of healthcare backgrounds. Commissioners are appointed to three-year renewable terms. An executive director and staff of analysts with backgrounds in economics, health policy, public health, and medicine support the agency.
MedPAC holds monthly public meetings in Washington, D.C., to discuss Medicare issues and policy questions, and to formulate recommendations to Congress. Meetings include research presentations by MedPAC staff, policy experts, and interested parties. Each meeting allows time for public comment.
The commission provides its recommendations to Congress in biannual reports, issued in March and June. MedPAC also advises Congress through comment on reports and proposed regulations issued by the U.S. Department of Health and Human Services (HHS), testimony, and briefings for congressional staff.
