On September 7-8, 2017, the Medicare Payment Advisory Commission (MedPAC) had the first meeting of their new term. The meeting contained sessions that mostly focused on providing Commissioners with information about various Medicare-related topics that could be areas for further exploration. No policy recommendations were discussed or voted on. In addition, the meeting introduced the Commission’s two newest members. Dana Gelb Safran, the Chief Performance Measurement and Improvement Officer and Senior Vice President of Enterprise Analytics at Blue Cross Blue Shield of Massachusetts has joined the Commission along with David Grabowski, a professor in the Department of Health Care Policy at Harvard Medical School.
The first sessions of the meeting were educational, providing commissioners with general information about Medicare coverage and spending. Staff discussed rising spending and factors that will contribute to the overall solvency of the Medicare program. Many of the Commissioners responded to this information by expressing a need for a sense of urgency to the work MedPAC is doing, saying that the Commission should evaluate policies that could have the biggest impact. When discussing spending, multiple Commissioners also expressed a hope that MedPAC would dive further into drug pricing issues, suggesting that the commissioner consider the entire supply chain as well as the impact of specialty drugs.
Later in the day, MedPAC staff gave a presentation about telehealth services in Medicare. The 21st Century Cures Act passed in late 2016 directed MedPAC to do a report on telehealth, looking at telehealth services that are paid for in Medicare fee-for-service (FFS) and in private insurance as well as ways to incorporate these services into Medicare FFS. In their discussion, Commissioners were curious about how to best utilize telehealth services, but some expressed a need for a better definition of what constitutes telehealth to help guide future conversations. Overall, the Commissioners seemed hopeful about possible benefits from telehealth and exploring areas where MedPAC could provide beneficial input.
An additional session focused on pharmacy benefit managers (PBMs) and specialty pharmacies. The presentation by MedPAC staff discussed the roles of PBMs and specialty pharmacies and their relation to Part D plans. Commissioners discussed the complexity of these relationships and considered the impact of these organizations, particularly on drug prices. In addition, Commissioner comments suggested that this topic has a place in a broader analysis of drug pricing that MedPAC could conduct. They asserted that PBMs and specialty pharmacists are certainly one area worth exploring, but that there are many other stakeholders and factors that play a role in rising drug prices.
The next public MedPAC meeting will be October 5-6, 2017 at the Ronald Reagan Building International Trade Center.