Medicare Compliance & Reimbursement

MedPAC also wants to coordinate care for patients with chronic conditions.

The Centers for Medicare & Medicaid Services could make the tangled process of figuring out practice expenses a lot easier, according to the Medicare Payment Advisory Commission.

CMS could set a schedule to review clinical staff wages and supply costs on a regular basis. The agency also could review the costs of more expensive and newer items more often than other items, commissioners say. And finally, CMS could scrap the assumption that providers use each piece of equipment at 50 percent of its capacity.

Currently, CMS figures out costs for each specialty and then allocates those costs to individual services in a "top-down" approach. CMS wants to move to a "bottom-up" approach, using data for services to figure out overall practice expenses.

MedPAC also wants to consider ways to coordinate care of chronic patients across different settings. Medicare could coordinate their care using a large physician group practice or other large organization, or by having the physician office interact with an external care management organization.