It's no longer just a home health copay: In its June report to Congress, MedPAC suggests a redesign for Medicare that would redefine beneficiary cost-sharing for services.

The cost-sharing model would establish a set systen of copays for different services, such as the $150 for certain home health episodes the commission had recommended before. It also would include a 20% coinsurance for durable medical equipment and a flat $80 copay per day of a SNF stay.

The suggested redesign would have a $5,000 out-of-pocket maximum "to protect beneficiaries from the financial risk of very high Medicare costs," the report states.

Other chapters of the report discuss care coordination for Medicare fee-for-service beneficiaries (no recommendations) and for dual eligibles. The report analyzes the benefits of several existing programs for dual eligibles and recommends changes to the Program for All-Inclusive Care for the Elderly (PACE). For example, MedPAC suggests developing quality measures that would lay the ground for a PACE bonus program.

The full report is available here.