MedPAC meets for October meeting

On October 8, the Medicare Payment Advisory Commission (MedPAC) held its Fall meeting, with the discussion focusing on Medicare Advantage (MA) provider networks and access to specialized care. The discussion highlighted evidence that provider directories may not fully reflect the physicians who treat MA enrollees, raising concerns about whether beneficiaries have accurate information when selecting plans and providers. Radiation oncology reflected 16% of encounters that involved a physician who was not listed in an MA enrollee’s plan directory. Commissioners also examined access to cancer care through MA networks, noting the critical role that specialized cancer centers play in treating complex cases. Discussion focused on the potential implications of expanding requirements related to National Cancer Institute (NCI)-designated cancer centers, including concerns about market leverage and the higher costs associated with care delivered at these facilities.
Commissioners also reviewed issues related to physician payment accuracy and clinician quality programs. A key area of focus was telehealth, with discussion centered on whether current Medicare payments appropriately reflect the resources required to provide virtual care and whether additional analysis is needed as telehealth becomes a permanent component of care delivery. Commissioners also revisited concerns about the burden and effectiveness of existing clinician quality reporting programs, noting ongoing questions about whether current approaches improve care quality sufficiently to justify their administrative complexity and costs.