MedPAC Report Highlights Key Medicare Policy Shifts Impacting Hearing Health

On June 12, 2025, the Medicare Payment Advisory Commission (MedPAC) delivered its annual June report to Congress, offering critical policy guidance on Medicare payment systems, delivery models, and overall market trends.

This year’s analysis covers two major health care areas affecting hearing health:

Physician Fee Schedule (PFS) Reform

• MedPAC advocates replacing current-law updates of the PFS with annual adjustments for inflation tied to a portion of the Medicare Economic Index (e.g., MEI minus 1 percent).

Supplemental Benefits in Medicare Advantage

• Medicare Advantage (MA) plans are projected to receive $86 billion in rebate funding in 2025—up from $21 billion in 2018—amounting to about $2,530 per enrollee. 
• Expanded Hearing Benefits: MA plans have increasingly offered hearing services, alongside dental and vision, funded through the rebate allowance.
• Data Gaps: Despite some encounter records for hearing, MedPAC highlights that reporting remains spotty, especially for services lacking standardized codes.
• Value Unclear: MedPAC underscores the difficulty in determining whether investments in hearing benefits deliver measurable improvements in enrollee health.
• Centers for Medicare and Medicaid Services (CMS) Action Underway: New data submission rules aim to enhance transparency, but meaningful insights will lag in becoming available.

Other important issues highlighted:

• Nursing Homes: Focuses on long‑stay beneficiaries and specialized institutional special‑needs plans.
• Rural Quality Reporting: Identifies challenges of quality metrics in low-volume rural settings.
• Critical Access Hospitals (CAHs): Recommends tying outpatient cost-sharing to Medicare payment (not charges) and capping coinsurance at the inpatient deductible ($1,676 in 2025).

MedPAC’s June 2025 report provides a comprehensive assessment of Medicare’s evolving landscape, while noting the lack of reusable and transparent data to fully understand program benefits across all segments of health care. While hearing health is part of a broader thrust toward supplemental benefits, persistent data shortcomings limit clarity on utilization and outcomes. CMS’s enhanced reporting initiative marks a promising step—if slow—in finally illuminating the true value of these services, including hearing, for seniors under Medicare Advantage. The Academy will continue to work with MedPAC and all health-care policy influencers to improve hearing health.