MedPAC debates what form a Medicare without fee-for-service payment might take

MedPAC plans to focus heavily on value-based payment in the coming months, and at its meeting Thursday the commissioners weighed what a Medicare without fee-for-service might look like. Eric Rollins, a principal policy analyst for the Medicare Payment Advisory Commission, outlined several scenarios that could unfold if volume-based payments are further phased out or eliminated entirely.  These models are based on what’s worked and what hasn’t today in accountable care organizations (ACOs) and Medicare Advantage (MA), he said. Both programs have challenges that will need to be addressed if they become the foundation for further work on value-based care. For example, the government actually pays slightly more in MA, he said, and ACO savings have been sluggish—though that is showing signs of changing.