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Policy
MedPAC chair: It’s about

The role of social determinants of
health is a very important issue broadly.
analytics, not politics
I don’t know how that impacts a range
of things in the Medicare program
recommendation-wise, but being
aware of the social determinants
Michael Chernew in late May was named chairman of the Medicare
issues is important; COVID illustrates
Payment Advisory Commission. Chernew, a professor of health policy at
some of the challenges that our
healthcare system faces across diff erent
Harvard Medical School, is no stranger to MedPAC. He was a member of the
communities.
congressional advisory panel from 2008 to 2014, serving as vice chair for the last
Administrative costs are a really
two years of his term. He discussed some of
big deal for me. We have created a
his goals with Modern Healthcare’s rules and On his areas of interest
regulation reporter Michael Brady. complicated Medicare program and
the extent to which we can fi nd ways
to reduce its complexity, reduce the
On becoming chairman related administrative costs … the
I think it’s recognized that I am a recommendations that we make will
nonpartisan. I view it as an analytics, be very important to me. I don’t think
not a political exercise, for example, we collectively spend enough time
and I have tremendous respect for the understanding the administrative burden
institution. I think it’s important for associated with the various things we do.
MedPAC to provide the best analysis The third one is low-value care. It’s

possible to support congressional really important to have a Medicare
leaders on both sides of the aisle. … I’m program where benefi ciaries have
very aware that policy has a number of “Administrative access to high-quality care. Th ere’s
considerations beyond the analytics. costs are a really wide variation in utilization patterns
big deal for me.” and not all care would be considered
On the impact of COVID-19 appropriate or high-value.

It’s not completely clear how COVID Michael Chernew The Choosing Wisely campaign

will affect things in a substantive way. Chairman of the Medicare illustrates that. Understanding things
MedPAC’s fundamental mission is to Payment Advisory Commission we might be able to do in Medicare

make recommendations, to promote to promote efficiency, to discourage
beneficiary access to effi cient, high- use of low-value care and encourage

quality care. COVID has just sent shock focuses on are influenced one way or use of high-value care would be

waves through the healthcare system. another by the COVID pandemic. important. That’s hard to do with the

There’s just an enormous number of tools that the Medicare program has,
related questions—from how to support On the biggest challenges facing but it’s important to understand and
a sustainable delivery system given the MedPAC to at least think about those and the
financial stress they’re under due to (They are the) same as the biggest recommendations that anyone makes.

COVID, how all the diff erent programs challenges facing the country: how do The last one, which I don’t think

that MedPAC looks at we set up payment systems is surprising to a lot of people, there

are affected in micro or to promote high-quality continues to be a lot of concern about
macro ways by COVID, THE TAKEAWAY care in an effi cient way? the primary-care system.

what happens to Medicare The blocking and tackling I am interested in understanding
Advantage, what happens The Medicare of MedPAC involves, for more and thinking about policies to
to alternative payment Payment Advisory example, how do we set support primary care in this country
Commission’s new
models. Some of it is chairman, Michael the (Medicare) updates in because (some) have argued that it is
complicated and technical, Chernew, says it a reasonable way, how do quite challenged. We at least need to
like what happens to risk is important for we deal with challenges think about the health of the primary-
adjustments or those types the commission to … like the baseline care system as we go forward.
of questions. I’m not sure continue to provide trajectories that you see These are (my) areas of interest.

MedPAC will take on all of Congress with in MACRA (and) all the MedPAC’s main goal is to be responsive
those questions, but the unbiased analysis productivity adjustments. to Congress and provide information
point is the vast majority of big issues facing It’s all of those questions that the congressional members and
of topics that MedPAC Medicare. that plague Medicare. their staff need. 
10 Modern Healthcare | June 8, 2020