The Medicare Payment Advisory Commission today discussed policy options to preserve access to emergency care in rural areas in the wake of recent rural hospital closures. Staff presented two potential models that would allow rural prospective payment system and critical access hospitals to convert to a 24/7 emergency department or primary care clinic with 24/7 ambulance service. Hospitals choosing the ED-only model would receive hospital outpatient PPS rates per service and fixed grants to help pay for standby capacity costs, while payment for the clinic model would be similar to a federally qualified health center. In other sessions at the two-day meeting, commissioners discussed the Medicare Access and CHIP Reauthorization Act’s new payment models for physicians, Medicare drug spending, and Medicare Advantage benchmarks, risk scores and star ratings.