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Medicare Payment Advisory Committee (MedPAC)

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Namestring
Medicare Payment Advisory Committee (MedPAC)
Legal namestring
Medicare Payment Advisory Commission
Websiteurl
medpac.gov
Company typeenum
Private
Founded yearint
1997
Descriptiontext

The Medicare Payment Advisory Committee (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997 to advise the U.S. Congress on Medicare payment policy. Headquartered at 425 I Street NW, Suite 701 in Washington, DC, MedPAC operates as a nonpartisan legislative branch body that produces empirical analyses and policy recommendations on Medicare payment systems, healthcare delivery reform, and program sustainability.

MedPAC's core outputs consist of two flagship annual Reports to Congress—a March Report on Medicare Payment Policy and a June Report on Medicare and the Health Care Delivery System—supplemented by an annual Data Book on Health Care Spending and the Medicare Program, comment letters on CMS proposed rules, congressional testimony, fact sheets, contractor reports, and a Payment Basics educational series. Its work spans 11 research areas including hospitals, post-acute care, ambulatory care, physicians, private plans (Medicare Advantage), beneficiaries, drugs/devices/tests, and quality. The commission has produced approximately 2,976 documents since 1999 and conducts longitudinal empirical analysis of provider margins (2013-2024 data period) and Medicare Advantage risk score growth patterns. Notable recent recommendations include a 7% cut to home health base payment rates for 2027 (projected $750M-$2B one-year savings) and elimination of hospice rate increases for FY2027 ($250M-$750M one-year savings).

MedPAC does not operate as a commercial entity. It is funded entirely through congressional appropriations, distributes all publications free of charge via its official website (medpac.gov), and serves a single primary customer: the U.S. Congress. Its commissioners are appointed by the Comptroller General of the United States (GAO head), and it maintains a small staff of 11-50 employees. Revenue is nil in the commercial sense; its economic impact is measured in the Medicare spending it influences through policy recommendations rather than fees or product sales.

Short descriptiontext

MedPAC is an independent U.S. congressional agency that provides nonpartisan analysis and policy recommendations to Congress on Medicare payment systems, healthcare delivery, and program sustainability through reports, data books, and testimony.

Operating statusenum
Operating
Ownership categoryenum
Headcount rangeband
11–50
akta.pro rankint
HeadquartersWashington, United States
HQ citystring
Washington
HQ countrystring
United States
HQ regionstring
North America
Markets served

Serves global market

Offices1 record

Each record includes

City, Country, Type, Description, Source

Keyword5 values
healthcare policy analysis, Medicare payment policy, congressional advisory services, healthcare reimbursement analysis, federal healthcare research
Industry3 codes
1Medicare Quality, Risk Adjustment & Stars Analytics/Services
CodeFSAIAGAJPrimaryYes
2MA-PD Plans (Medicare Advantage with Prescription Drug Coverage)
CodeFSAIAGAGPrimaryNo
3Medigap Plan Administration (Enrollment, Billing & Member Services)
CodeHLAEADACPrimaryNo
Product category
Federal Healthcare Policy Advisory Services
Marketing channels4 records

Each record includes

Title, Type, Stage, Description, Source

Distribution channels1 record

Each record includes

Title, Type, Scope, Target buyer, Description, Source

Cost components4 values
Personnel, Operations, Technology or R&D, Others
GTM typeB2B
B2B
Offering typeServices
Services
Core offering1 text field

MedPAC is a nonpartisan independent legislative branch agency that provides the U.S. Congress with analysis and policy advice on the Medicare program. It produces annual reports to Congress on Medicare Payment Policy (March) and Medicare and the Health Care Delivery System (June), supplemented by data books, comment letters on CMS proposed rules, congressional testimony, fact sheets, and contractor reports covering 11 research areas including hospitals, post-acute care, physicians, Medicare Advantage, and beneficiaries.

Differentiator
Functional benefit
Problem solved
Quantifiable outcome1 of 3 values shown
  • 7% cut recommendation for home health Medicare base payment rates for 2027 would decrease Medicare spending by $750 million to $2 billion in one year and $10 billion to $25 billion over five years
+2 more records
Product overview1 text field

MedPAC is a nonpartisan independent legislative branch agency that provides analysis and policy advice to the U.S. Congress on the Medicare program. The organization operates as a publication-based advisory body rather than a technology product company. Its core offerings consist of two major annual reports to Congress (March Report on Medicare Payment Policy and June Report on Medicare and the Health Care Delivery System), supported by supplementary publications including the Data Book, Comment Letters on CMS proposed rules, Congressional Testimony, Fact Sheets, Press Releases, RFI Responses, Contractor Reports, and the Payment Basics educational series. These publications cover 11 research areas: Hospitals, Post-Acute Care, Ambulatory Care Settings, Delivery System Reforms, Physicians and Other Health Professionals, Private Plans (including Medicare Advantage), Beneficiaries and Coverage, Medicare Spending and Financing, Drugs, Devices, and Tests, Quality, and Regional Issues.

Product and service8 records
1Reports to the Congress
CategoryPolicy Reports
Description

MedPAC publishes two major reports to Congress each year - the March Report on Medicare Payment Policy and the June Report on Medicare and the Health Care Delivery System. These reports contain analysis, recommendations, and empirical data on Medicare payment adequacy and healthcare delivery system issues.

2Data Book
CategoryData Publications
Description

Annual data publications providing comprehensive statistics on Medicare spending, enrollment, and program metrics for researchers and policymakers.

3Comment Letters
CategoryRegulatory Comments
Description

Formal responses to CMS proposed rules and congressional requests for information on Medicare policy matters.

4Congressional Testimony
CategoryCongressional Communications
Description

Formal testimony provided to congressional committees on Medicare-related issues, payment policy, and healthcare delivery.

5Payment Basics
CategoryEducational Resources
Description

Educational series explaining Medicare's various payment systems for healthcare providers, designed to help stakeholders understand the complex reimbursement landscape.

6Contractor Reports
CategoryResearch Publications
Description

Research reports commissioned by MedPAC on topics including physician surveys, drug spending, and medical technology payment policies.

7Fact Sheets
CategoryEducational Resources
Description

Concise summaries of Medicare payment policies, program statistics, and MedPAC recommendations for policymakers and stakeholders.

8RFI Responses
CategoryCongressional Communications
Description

Responses to Congressional Requests for Information on various Medicare policy topics including primary care reform, rural health access, and dual-eligible beneficiaries.

Scale indicator4 records

Each record includes

Type, Value, Description, Source

Partnership1 partner
Strategic tierCoreTypeStrategic or Co-development PartnerAnnounced on2026-09-03
Description

GAO Comptroller General Gene Dodaro presented at MedPAC's September 2026 meeting on GAO's work on reducing improper payments and improving program integrity. The GAO also makes MedPAC commissioner appointments.

Recent move6 records

Each record includes

Date, Type, Title, Description, Source

Expansion highlight4 records

Each record includes

Type, Description

Peers10 records
TypeDirect peer
Description

The Congressional Research Service (CRS) provides nonpartisan policy analysis exclusively to Congress, covering Medicare alongside many other topics. It is a direct peer in operating as a confidential legislative branch analytical resource serving congressional decision-making.

TypeEmerging player
Description

The National Academy of Social Insurance is a nonprofit, nonpartisan organization that studies Social Security, Medicare, and other social insurance programs. It is an emerging player providing Medicare policy analysis with a narrower scope than MedPAC but a similar nonpartisan analytical orientation.

TypeEmerging player
Description

The Bipartisan Policy Center is a Washington think tank that produces healthcare policy recommendations including work on Medicare reform. It is an emerging player that operates with a more advocacy-oriented posture than MedPAC but covers overlapping Medicare policy terrain.

TypeBroad incumbent
Description

CMS is the executive branch agency that administers Medicare and is the primary recipient of MedPAC's recommendations. It is a broad incumbent that issues its own payment rules and analyses, overlapping with MedPAC's domain but operating under different statutory authority.

TypeEmerging player
Description

The Center for Medicare and Medicaid Innovation (CMMI) develops and tests new payment and delivery models within Medicare. It is an emerging player in Medicare payment reform whose work frequently intersects with MedPAC's payment adequacy analyses and recommendations.

TypeBroad incumbent
Description

The Commonwealth Fund is a private foundation supporting independent health policy research, including significant work on Medicare payment reform. It is a broad incumbent in producing Medicare-relevant analyses that inform policymakers alongside MedPAC's work.

TypeBroad incumbent
Description

KFF is a leading nonpartisan health policy research organization that produces widely-cited analyses on Medicare, Medicaid, and the broader U.S. healthcare system. It overlaps with MedPAC's analytical domain but operates as an external nonprofit rather than a congressional agency.

TypeDirect peer
Description

The Congressional Budget Office (CBO) is a sister nonpartisan legislative branch agency that provides Congress with economic and budgetary analysis. Like MedPAC, it produces quantitative analyses that inform Medicare and broader federal spending legislation, making it the most directly comparable federal policy advisory peer.

TypeDirect peer
Description

The GAO is a legislative branch agency that audits federal programs, including Medicare, and actually appoints MedPAC's commissioners. It is a direct peer in providing nonpartisan oversight and analysis to Congress on Medicare program integrity and improper payments.

TypeDirect peer
Description

The Medicare Board of Trustees issues the annual Medicare Trustees Report on the program's financial status. It is a direct peer in providing Congress with forward-looking analysis of Medicare's sustainability, complementing MedPAC's payment policy work.

Market position
Strengths4 records

Each record includes

Headline, Details, Source

Weaknesses4 records

Each record includes

Headline, Details, Source

Competitive moat3 records

Each record includes

Type, Details

Key risks5 records

Each record includes

Headline, Details, Source

Key highlights6 records

Each record includes

Headline, Details, Source

Customer concentration

Classification, Details

Segment3 records

Each record includes

Title, Type, Primary, Description, Pain point addressed, Use case, Source

Ideal customer profile2 records

Each record includes

Profile, Firmographic size, Sales motion, Sales cycle length, Buying structure, Purchase trigger, Buyer persona, Geography, Industry vertical, Primary use case, Description, Pain points, Evidence proof points, Target buyer

Technology focused
No
API detail
Has APIbool
No

Docs URL, Description

AI maturity
App detail

Has app

Core technology
Revenue estimate
Valuation estimate
Number of profiles
No data
No data
Funding overview

Funding stage, Last funding date, Total funding USD

Funding rounds

Each record includes

Round, Amount USD, Date, Pre money valuation, Total investors, Investors, News

Investors

Each record includes

Name, Type, Date of entry, Rounds participated, Website

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Each record includes

Name, Acquisition type, Announced date, Completed date, Status, Website, News

Investment

Each record includes

Name, Round, Announced date, Lead investor, Website, News

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Medicare Payment Advisory Committee (MedPAC)

Federal Healthcare Policy Advisory Servicesmedpac.gov

MedPAC is an independent U.S. congressional agency that provides nonpartisan analysis and policy recommendations to Congress on Medicare payment systems, healthcare delivery, and program sustainability through reports, data books, and testimony.

What Medicare Payment Advisory Committee (MedPAC) does

The Medicare Payment Advisory Committee (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997 to advise the U.S. Congress on Medicare payment policy. Headquartered at 425 I Street NW, Suite 701 in Washington, DC, MedPAC operates as a nonpartisan legislative branch body that produces empirical analyses and policy recommendations on Medicare payment systems, healthcare delivery reform, and program sustainability.

MedPAC's core outputs consist of two flagship annual Reports to Congress—a March Report on Medicare Payment Policy and a June Report on Medicare and the Health Care Delivery System—supplemented by an annual Data Book on Health Care Spending and the Medicare Program, comment letters on CMS proposed rules, congressional testimony, fact sheets, contractor reports, and a Payment Basics educational series. Its work spans 11 research areas including hospitals, post-acute care, ambulatory care, physicians, private plans (Medicare Advantage), beneficiaries, drugs/devices/tests, and quality. The commission has produced approximately 2,976 documents since 1999 and conducts longitudinal empirical analysis of provider margins (2013-2024 data period) and Medicare Advantage risk score growth patterns. Notable recent recommendations include a 7% cut to home health base payment rates for 2027 (projected $750M-$2B one-year savings) and elimination of hospice rate increases for FY2027 ($250M-$750M one-year savings).

MedPAC does not operate as a commercial entity. It is funded entirely through congressional appropriations, distributes all publications free of charge via its official website (medpac.gov), and serves a single primary customer: the U.S. Congress. Its commissioners are appointed by the Comptroller General of the United States (GAO head), and it maintains a small staff of 11-50 employees. Revenue is nil in the commercial sense; its economic impact is measured in the Medicare spending it influences through policy recommendations rather than fees or product sales.

Medicare Payment Advisory Committee (MedPAC) firmographics

Firmographics
Name
Medicare Payment Advisory Committee (MedPAC)
Legal name
Medicare Payment Advisory Commission
Website
https://medpac.gov
Company type
Private
Founded year
1997
Operating status
Operating
Headcount range
11–50 employees
Short description
MedPAC is an independent U.S. congressional agency that provides nonpartisan analysis and policy recommendations to Congress on Medicare payment systems, healthcare delivery, and program sustainability through reports, data books, and testimony.
Ownership category
akta.pro rank

Medicare Payment Advisory Committee (MedPAC) industry classification

Industry
Product category
Federal Healthcare Policy Advisory Services
akta.pro primary industry
Medicare Quality, Risk Adjustment & Stars Analytics/Services (FSAIAGAJ)
akta.pro secondary industries
MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG), Medigap Plan Administration (Enrollment, Billing & Member Services) (HLAEADAC)

Keywords

  • Healthcare policy analysis
  • Medicare payment policy
  • Congressional advisory services
  • Healthcare reimbursement analysis
  • Federal healthcare research

Where Medicare Payment Advisory Committee (MedPAC) is headquartered

Location

Headquarters

HQ city
Washington
HQ country
United States
HQ region
North America

Offices1 record

Markets served

Medicare Payment Advisory Committee (MedPAC) business model

Business model
GTM type
B2B
Offering type
Services
Cost components
Personnel, Operations, Technology or R&D, Others

Distribution channels1 record

Marketing channels4 records

Medicare Payment Advisory Committee (MedPAC) product offering

Product offering

Core offering

MedPAC is a nonpartisan independent legislative branch agency that provides the U.S. Congress with analysis and policy advice on the Medicare program. It produces annual reports to Congress on Medicare Payment Policy (March) and Medicare and the Health Care Delivery System (June), supplemented by data books, comment letters on CMS proposed rules, congressional testimony, fact sheets, and contractor reports covering 11 research areas including hospitals, post-acute care, physicians, Medicare Advantage, and beneficiaries.

Product overview

MedPAC is a nonpartisan independent legislative branch agency that provides analysis and policy advice to the U.S. Congress on the Medicare program. The organization operates as a publication-based advisory body rather than a technology product company. Its core offerings consist of two major annual reports to Congress (March Report on Medicare Payment Policy and June Report on Medicare and the Health Care Delivery System), supported by supplementary publications including the Data Book, Comment Letters on CMS proposed rules, Congressional Testimony, Fact Sheets, Press Releases, RFI Responses, Contractor Reports, and the Payment Basics educational series. These publications cover 11 research areas: Hospitals, Post-Acute Care, Ambulatory Care Settings, Delivery System Reforms, Physicians and Other Health Professionals, Private Plans (including Medicare Advantage), Beneficiaries and Coverage, Medicare Spending and Financing, Drugs, Devices, and Tests, Quality, and Regional Issues.

Differentiator

Problem solved

Functional benefit

Products and services

  • Reports to the Congress MedPAC publishes two major reports to Congress each year - the March Report on Medicare Payment Policy and the June Report on Medicare and the Health Care Delivery System. These reports contain analysis, recommendations, and empirical data on Medicare payment adequacy and healthcare delivery system issues.
  • Data Book Annual data publications providing comprehensive statistics on Medicare spending, enrollment, and program metrics for researchers and policymakers.
  • Comment Letters Formal responses to CMS proposed rules and congressional requests for information on Medicare policy matters.
  • Congressional Testimony Formal testimony provided to congressional committees on Medicare-related issues, payment policy, and healthcare delivery.
  • Payment Basics Educational series explaining Medicare's various payment systems for healthcare providers, designed to help stakeholders understand the complex reimbursement landscape.
  • Contractor Reports Research reports commissioned by MedPAC on topics including physician surveys, drug spending, and medical technology payment policies.
  • Fact Sheets Concise summaries of Medicare payment policies, program statistics, and MedPAC recommendations for policymakers and stakeholders.
  • RFI Responses Responses to Congressional Requests for Information on various Medicare policy topics including primary care reform, rural health access, and dual-eligible beneficiaries.

Quantifiable outcome

  • 7% cut recommendation for home health Medicare base payment rates for 2027 would decrease Medicare spending by $750 million to $2 billion in one year and $10 billion to $25 billion over five years
  • +2 more outcomes

Companies that use Medicare Payment Advisory Committee (MedPAC)

Customer profile

Segments3 records

Ideal customer profiles2 records

Medicare Payment Advisory Committee (MedPAC) technology and API

Technology

Technology focussed No

API detail

Has API
No
API docs
API detail

Core technology

AI maturity

App detail

Medicare Payment Advisory Committee (MedPAC) partnerships and signals

Strategic signal

Partnerships

One partnership is on record.

  • U.S. Government Accountability Office (GAO)coreStrategic or Co-development Partner · 3 September 2026GAO Comptroller General Gene Dodaro presented at MedPAC's September 2026 meeting on GAO's work on reducing improper payments and improving program integrity. The GAO also makes MedPAC commissioner appointments.

Scale indicators4 records

Recent moves6 records

Expansion highlights4 records

Medicare Payment Advisory Committee (MedPAC) competitors and assessment

Company assessment

Direct peers

  • Congressional Research Service: The Congressional Research Service (CRS) provides nonpartisan policy analysis exclusively to Congress, covering Medicare alongside many other topics. It is a direct peer in operating as a confidential legislative branch analytical resource serving congressional decision-making.
  • Congressional Budget Office: The Congressional Budget Office (CBO) is a sister nonpartisan legislative branch agency that provides Congress with economic and budgetary analysis. Like MedPAC, it produces quantitative analyses that inform Medicare and broader federal spending legislation, making it the most directly comparable federal policy advisory peer.
  • Government Accountability Office: The GAO is a legislative branch agency that audits federal programs, including Medicare, and actually appoints MedPAC's commissioners. It is a direct peer in providing nonpartisan oversight and analysis to Congress on Medicare program integrity and improper payments.
  • Medicare Board of Trustees: The Medicare Board of Trustees issues the annual Medicare Trustees Report on the program's financial status. It is a direct peer in providing Congress with forward-looking analysis of Medicare's sustainability, complementing MedPAC's payment policy work.

Emerging players

  • National Academy of Social Insurance: The National Academy of Social Insurance is a nonprofit, nonpartisan organization that studies Social Security, Medicare, and other social insurance programs. It is an emerging player providing Medicare policy analysis with a narrower scope than MedPAC but a similar nonpartisan analytical orientation.
  • Bipartisan Policy Center: The Bipartisan Policy Center is a Washington think tank that produces healthcare policy recommendations including work on Medicare reform. It is an emerging player that operates with a more advocacy-oriented posture than MedPAC but covers overlapping Medicare policy terrain.
  • Medicare Payment Innovation Center (CMMI): The Center for Medicare and Medicaid Innovation (CMMI) develops and tests new payment and delivery models within Medicare. It is an emerging player in Medicare payment reform whose work frequently intersects with MedPAC's payment adequacy analyses and recommendations.

Broad incumbents

  • Centers for Medicare & Medicaid Services: CMS is the executive branch agency that administers Medicare and is the primary recipient of MedPAC's recommendations. It is a broad incumbent that issues its own payment rules and analyses, overlapping with MedPAC's domain but operating under different statutory authority.
  • Commonwealth Fund: The Commonwealth Fund is a private foundation supporting independent health policy research, including significant work on Medicare payment reform. It is a broad incumbent in producing Medicare-relevant analyses that inform policymakers alongside MedPAC's work.
  • Kaiser Family Foundation: KFF is a leading nonpartisan health policy research organization that produces widely-cited analyses on Medicare, Medicaid, and the broader U.S. healthcare system. It overlaps with MedPAC's analytical domain but operates as an external nonprofit rather than a congressional agency.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat3 records

Key risks5 records

Key highlights6 records

Customer concentration

Medicare Payment Advisory Committee (MedPAC) social profiles

Digital presence

Medicare Payment Advisory Committee (MedPAC) financial estimates

Financial estimate

Revenue estimate

Valuation estimate

Medicare Payment Advisory Committee (MedPAC) leadership team

Management profile

Number of profiles

Medicare Payment Advisory Committee (MedPAC) funding detail

Funding detail

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

Medicare Payment Advisory Committee (MedPAC) M&A and investment

M&A and investment

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Medicare Payment Advisory Committee (MedPAC)

What does Medicare Payment Advisory Committee (MedPAC) do?

MedPAC is a nonpartisan independent legislative branch agency that provides the U.S. Congress with analysis and policy advice on the Medicare program. It produces annual reports to Congress on Medicare Payment Policy (March) and Medicare and the Health Care Delivery System (June), supplemented by data books, comment letters on CMS proposed rules, congressional testimony, fact sheets, and contractor reports covering 11 research areas including hospitals, post-acute care, physicians, Medicare Advantage, and beneficiaries.

Is Medicare Payment Advisory Committee (MedPAC) a public or private company?

Medicare Payment Advisory Committee (MedPAC) is a private company. It is classified as state government owned and is currently operating.

When was Medicare Payment Advisory Committee (MedPAC) founded?

Medicare Payment Advisory Committee (MedPAC) was founded in 1997. It employs 11 to 50 people.

Where is Medicare Payment Advisory Committee (MedPAC) based?

Medicare Payment Advisory Committee (MedPAC) is headquartered in Washington, United States, in the North America region.

Who are Medicare Payment Advisory Committee (MedPAC)'s main competitors?

Direct peers on record are Congressional Research Service, Congressional Budget Office, Government Accountability Office and Medicare Board of Trustees. Emerging players are National Academy of Social Insurance, Bipartisan Policy Center and Medicare Payment Innovation Center (CMMI). Broad incumbents are Centers for Medicare & Medicaid Services, Commonwealth Fund and Kaiser Family Foundation.

Does Medicare Payment Advisory Committee (MedPAC) have an API?

No public API is recorded for Medicare Payment Advisory Committee (MedPAC).

What industry is Medicare Payment Advisory Committee (MedPAC) in?

Medicare Payment Advisory Committee (MedPAC)'s product category is Federal Healthcare Policy Advisory Services. Its primary akta.pro industry code is FSAIAGAJ, Medicare Quality, Risk Adjustment & Stars Analytics/Services, with a secondary code of FSAIAGAG, MA-PD Plans (Medicare Advantage with Prescription Drug Coverage).

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Live signals
STATGOP aims to change Medicare adviser’s math so it's more favorable to health insurersHouse Ways and Means Republicans voted to change how the Medicare Payment Advisory Commission studies Medicare Advantage spending, making it more favorable to insurers. MedPAC estimated Medicare will pay 14% more per enrollee, or $76 billion, to Advantage plans than traditional Medicare.Knowledge at WhartonPenn health economist on shaping Medicare’s futureAmol Navathe, a professor of health policy and medicine at the University of Pennsylvania, has been appointed chair of the Medicare Payment Advisory Commission (MedPAC), the independent congressional agency that advises Congress on Medicare payment policy, access, and quality. The appointment comes at a critical juncture as Medicare, covering more than 67 million beneficiaries, faces significant financial sustainability pressures alongside rapid technological changes including AI-based healthcare services. Navathe has outlined priorities of balancing access to innovative technologies with fiscal prudence while improving care delivery and behavioral health access.Medical NewsBrokers Get Paid More to Enroll Seniors in Medicare Advantage. Is That a Problem?Members of the Medicare Payment Advisory Commission (MedPAC) are calling for changes to the compensation structure that pays brokers significantly more to enroll seniors in Medicare Advantage plans compared to traditional Medicare. The commission highlighted concerns over the $6.9 billion in broker payouts and the structural underfunding of the State Health Insurance Assistance Program (SHIP), which provides unbiased counseling. Proposals to address these issues include indexing SHIP funding to enrollment growth or creating a fee pool funded by insurer commissions.FierceHealthcareThe feds will overpay Medicare Advantage plans by $76B this year, MedPAC estimatesThe Medicare Payment Advisory Commission (MedPAC) released its March report estimating the federal government will overpay Medicare Advantage plans by $76 billion in the current year compared to traditional Medicare spending, driven primarily by favorable selection and coding intensity practices. The advisory body also recommended that Congress blunt a scheduled 1.7-2.2% physician pay cut in FY2027 while maintaining the current hospital payment increase, citing stable beneficiary access and improved hospital margins. Industry groups including the Better Medicare Alliance and the American Medical Association responded, with the BMA challenging MedPAC's methodology and the AMA expressing disappointment that the commission did not recommend tying payments directly to rising input costs.HomehealthcarenewsInside MedPAC’s Home Health Recommendation And What It Means For The Industry’s FutureThe Medicare Payment Advisory Commission (MedPAC) voted to recommend a 7% cut to home health Medicare base payment rates for 2027, which would decrease Medicare spending by $750 million to $2 billion in one year and $10 billion to $25 billion over five years. Industry group the National Alliance for Care at Home criticized the recommendation, arguing that MedPAC's methodology for measuring access to care—focusing on the presence of agencies in ZIP codes rather than whether they actually accept patients—is flawed and inconsistent with how it treats skilled nursing facilities. A MedPAC member questioned the disparity between the 7% home health cut and the 4% skilled nursing cut given similar margin profiles, raising hopes for potential methodological changes.McknightsMedPAC commissioners cautious about post-acute regulation, payMedPAC commissioners at their December public meeting discussed post-acute care regulatory and payment issues, including the TEAMS alternative payment model launching in January, which will examine five high-cost procedures across 188 markets and assess hospital relationships with skilled nursing facilities, inpatient rehabilitation facilities, and home health operators. The commissioners expressed caution about moving toward unified site-neutral payments and called for stronger oversight of Medicare Advantage prior authorization practices while acknowledging that fee-for-service margins for SNFs, HHAs, and IRFs have exceeded 10% for over two decades. CMS plans to closely monitor post-acute provider case-mix changes and Medicare Advantage effects on SNF and IRF financial performance as the TEAM demonstration unfolds.Business Wire BlogMangrove Management Partners, The Vascular Care Group, and American Vascular Associates Commend CMS, MedPAC, and Dr. Oz for Actions that Support High-Quality, Lower-Cost Office-Based CareMangrove Management Partners, The Vascular Care Group, and American Vascular Associates issued a press release commending CMS, MedPAC, and Dr. Oz for the CY 2026 Physician Fee Schedule actions that support office-based procedural care. The final rule avoids approximately 15% cuts to office-based services, reverses prior reimbursement policies that reduced over 300 CPT codes below their direct costs, and addresses site-of-service payment disparities. The organizations view these policy changes as protecting patient access, ensuring fairness across sites of service, and reinforcing the cost-effectiveness of office-based vascular care delivery nationwide.CeiTop-down management can’t fix upcoding in Medicare AdvantageThe article argues that top-down regulatory measures by the Centers for Medicare & Medicaid Services (CMS) have failed to curb upcoding in Medicare Advantage plans because they do not address underlying incentives. Despite expanded audits and payment adjustments, the practice persists and may be worsening, according to the Medicare Payment Advisory Commission (MedPAC). The author suggests these broad constraints are counterproductive, potentially encouraging plans to increase coding intensity to avoid penalties.TheconsumervoiceMedPAC Releases Report on Medicare Spending in Long-Term Care FacilitiesMedPAC released a report on Medicare spending for long-term care facilities, highlighting a $30 billion expenditure and a 22% average profit margin for nursing homes in 2023. The report also discusses issues related to transparency in related party transactions and exemptions from staffing rules, especially in rural areas.StatistaNumber of Medicare home health users U.S.The article reports on the projected number of Medicare fee-for-service home health care users in the U.S. from 2019 to 2024, with data sourced from MedPAC and Statista. The data indicates an ongoing trend in utilization over this period.