MedPAC Releases June 2015 Data Book on Health Care Spending and the Medicare Program

The Medicare Payment Advisory Commission (MedPAC) released its June 2015 Data Book on Health Care Spending and the Medicare Program last week. The Data Book provides information on national health care and Medicare spending as well as Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care in the Medicare Program, and Medicare beneficiary and other payer liability. It examines provider settings and presents data on Medicare spending and beneficiaries’ access to care in each setting, as well as each setting’s profit margins. Additionally, MedPAC covers the Medicare Advantage program and prescription drug coverage for Medicare beneficiaries. MedPAC resumes its monthly meetings in September.

Study Finds Health Exchanges Have Fewer Providers Than Employer Plans

On average, insurance plans available to purchase through the health exchanges provide access to one-third fewer providers than plans offered through employer-provided coverage, according to a new study from Avalere Health. The marketplaces created by the Affordable Care Act (ACA) use narrow networks to contract with a limited number of providers who agree to be reimbursed at lower rates as a means of cost savings and keeping premiums low. Consumers, however, are subject to much higher out of pocket costs should they use a provider that is outside their plan’s network. These costs do not count towards consumer deductibles or out of pocket maximums. Compared to traditional employer coverage, plans on the exchange had networks with 42 percent fewer cancer and cardiac specialists, 32 percent fewer mental health and primary care providers, and 24 percent fewer hospitals.

Upcoming Congressional Meetings and Hearings

House Veterans’ Affairs Oversight and Investigations (O&I) Subcommittee: hearing titled “Lack of Oversight of Interagency Agreements - VA Procurement Failures Continued;” 4:00 p.m., 334 Cannon Bldg.; July 21

House Veterans’ Affairs Committee: hearing to Receive the Secretary’s Testimony regarding the Pending VA Health Care Budget Shortfall and System Shutdown; 10:00 a.m., 334 Cannon Bldg.; July 22

House Veterans’ Affairs Health Subcommittee: markup of pending legislation; 1:30 p.m., 334 Cannon Bldg.; July 22

House Ways and Means Health Subcommittee: hearing with MedPAC to discuss hospital payment issues, rural health issues, and beneficiary access to care; 10:00 a.m., B-318 Rayburn Bldg.; July 22

Senate Special Aging Committee hearing titled “ The Doctor’s Not In: Combating Medicare Provider Enrollment Fraud;” 2:15 p.m., 562 Dirksen Bldg.; July 22

Senate Health, Labor, Education, and Pensions Committee: hearing titled “Achieving the Promise of Health Information Technology: Information Blocking and Potential Solutions;” 10:00 a.m., 430 Dirksen Bldg.; July 23

House Energy and Commerce Oversight and Investigations Subcommittee: hearing titled “An Overdue Checkup: Examining the ACA’s [Affordable Care Act] State Insurance Marketplaces;” 9:15 a.m., 2123 Rayburn Bldg.; July 24

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