Executive Summary
As part of its mandate from the Congress, each June the Commission reports on improvements to Medicare payment systems and issues affecting the Medicare program, including changes to health care delivery and the market for health care services. The seven chapters of the June 2025 report cover the following topics:
• Reforming physician fee schedule updates and improving the accuracy of relative payment rates. The Commission recommends replacing the current-law updates to fee-for-service (FFS) Medicare’s physician fee schedule (PFS) with an annual update based on a portion of the growth in inflation, as measured by the Medicare Economic Index (MEI). The Commission also recommends that the relative accuracy of PFS payment rates be improved by collecting and using timely data that better reflect the relative costs of delivering care.
• Supplemental benefits in Medicare Advantage. The Commission reviews trends in Medicare’s spending for Medicare Advantage (MA) supplemental benefits, summarizes the types of supplemental benefits offered by MA plans, and assesses the potential utility of MA encounter data for measuring enrollees’ use of these benefits.
• Examining home health care use among Medicare Advantage enrollees. Using a combined dataset of the encounter and home health assessment data, the Commission assesses use of home health care by MA enrollees.
• Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage. The Commission describes how MA and Part D policies and other factors may be affecting trends in plan offerings and relative costs and payments for stand-alone prescription drug plans (PDPs) and MA Prescription Drug plans (MA–PDs).
• Medicare beneficiaries in nursing homes. The Commission describes the Medicare long-stay nursing home (NH) population and reviews regulations and programs that CMS has implemented to improve NH quality, including specialized MA plans known as institutional special-needs plans.
• Medicare’s measurement of rural provider quality. The Commission reviews the inclusion of rural providers in current Medicare FFS quality-reporting programs.
• Reducing beneficiary cost sharing for outpatient services at critical access hospitals. The Commission recommends that FFS beneficiary cost sharing for outpatient services provided at critical access hospitals be based on each hospital’s Medicare payment amount instead of on the hospital’s charges.
Excel files of the data underlying the figures in the chapters of this publication are available for download. Excel files are provided only when the data are not otherwise shown or labeled in the chapter.