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MedPAC discusses EHR program; recommends Medicare benefit redesign

April 5, 2012

Meeting today in Washington, the Medicare Payment Advisory Commission discussed the Medicare electronic health record incentive program. Several commissioners expressed concern about the small number of hospitals and eligible professionals - especially small independent hospitals and physician practices - who have successfully attested to "meaningful use" of EHRs to date. Commissioners also expressed interest in monitoring the program going forward to see whether EHR implementation facilitates system efficiencies and cost savings. In other business, the commission unanimously voted to recommend that Congress direct the Health and Human Services secretary to develop and implement a new Medicare Fee-For-Service benefit design to replace the current design. Commissioners expressed displeasure with the current benefit design and a desire for a more robust benefit package that is focused more on value. The proposed benefit design would include: an out-of-pocket maximum; deductible(s) for Parts A and B; and copayments (instead of coinsurance) that may vary by type of service and provider. The HHS secretary would be able to alter or eliminate cost-sharing, including the out-of-pocket maximum, based on evidence of the value of services. The proposal would not change the benefit aggregate cost sharing liability, and would include an additional charge on supplemental insurance.