; (B) improved health outcomes; (C) improved patient satisfaction; and (D) reduced spending under the Medicare program. (2) Report Not later than December 31, 2024, the Secretary shall submit to Congress a report on the evaluation conducted under paragraph (1). (3) Coordination with expanding choice for medicaid inpatient psychiatric hospital services demonstration project The Secretary may combine the independent evaluation and reports required under this section and the reports required under the demonstration project under section 2(f). (f) Budget neutrality With respect to the period of the pilot program under subsection (c)(1) occurring before any expansion under subparagraph (C) of such subsection, the Secretary shall ensures that program does not result in a net increase in the aggregate expenditures under the Medicare program for such period above the level of such expenditures if the pilot program had not been implemented. The Secretary may make such adjustments to payments under the Medicare program as is necessary to carry out the previous sentence.