The Medicare Payment Advisory Commission today discussed potential Medicare policy responses to consolidation and integration in the health care market, ranging from expanding site-neutral payment to making it easier for providers to participate in accountable care organizations. Commissioners had varying opinions about the best approach, noting that consolidation can have both good and bad effects and the need to understand the forces behind consolidation before making recommendations. Other topics covered during the meeting included options for assessing the growth of stand-alone emergency departments in urban and suburban areas; potential changes to Medicare outlier payments; and potential methods for determining benchmarks and beneficiary premiums under a Medicare premium support system. The commission also considered how to modify the Open Payments program to require reporting of payments to advanced practice nurses, physician assistants and patient advocacy organizations, and improve reporting about drug samples.