Facilities: Four of the sessions sought to coordinate payment and delivery of care across multiple settings through the equalization of payments, aligning delivery of care across payment models (specifically FFS, MA and ACOs), and harmonizing quality measures. These changes are likely to lead to reduced payments in certain settings of care, specifically in inpatient rehabilitation facilities, which will put financial pressure on facilities that will have to operate under tighter budgets.
- Life Sciences: The Commission’s interest in promoting the development of a more effective system to determine payment rates for Part B drugs and new therapies based on comparative clinical evidence signals Congress and the Centers for Medicare & Medicaid Services’ (CMS’) concerns over growing Part B drug spend, as well as an interest in moving away from the Average Sales Price (ASP) payment methodology. While it may be too politically challenging to reinstate a Least Costly Alternative (LCA) policy, it is likely that MedPAC, CMS and Congress will continue to push for Part B payment reforms in the near future.
- Providers: The proposals to refine quality measurement under Medicare would push providers to be more accountable for the care they are delivering to Medicare beneficiaries. Additionally, proposals to incentivize primary care may push more providers to pursue primary care as opposed to specialties.