Medicare's Next 50 Years: More Home Care, Less Red Tape
Written by Editor   
Monday, August 10, 2015 12:00 AM

Medicare is 50 years old and both political parties have ideas for its improvement.  These include promoting a broader role for the program with guaranteed benefits, and supporting curbing federal spending, privatizing benefits and shifting towards a "defined contribution" system. More innovation and competition and less government oversight are what's needed to improve care and reduce cost this report cites.

Medicare and Medicaid combined provide healthcare to more than 111 million Americans, which supports 55 million Americans -- including 9 million disabled individuals -- cost the federal government $587.5 billion in 2013. 

In general, the two major political parties each have different plans for Medicare – Democrats promoting a broader role for the program with guaranteed benefits, and Republicans supporting curbing federal spending, privatizing benefits and shifting towards a "defined contribution" system.

The ranking member of the Senate Finance Committee described four critical areas for which he believes Medicare will set the precedent for the rest of the industry for the next 50 years. The first involves reducing hospital care and doctor visits by leveraging home care leading a revolution in caring for people at home, especially for chronic illnesses such as cancer, diabetes, stroke, and Alzheimer's, which account for 93% of Medicare's costs.

Medicare's response to high-cost prescription drugs is a second area where the benefit program can have an impact. New Hepatitis C drugs -- which costs roughly $84,000 for a 12-week course -- and the recently approved class of lipid-lowering PCSK9 inhibitors, whose annual costs have been estimated at $7,000-$12,000, present huge obstacles for health spending.

Third, the significance of "user-friendly" healthcare data in Medicare's future, and finally, he encouraged the use of innovative approaches to end-of-life care that allows patients the option of continuing treatment even after they've started hospice care.

The chairman of the House Ways and Means Health Subcommittee called for a broad redesign of the benefits program for seniors. "Medicare, the way it's currently financed and structured, just isn't set for the long term," he said, noting that the Medicare hospital trust fund is currently projected to dry up in the next 15 years.

He also highlighted the "challenging" demographics responsible for this problem: the growing senior population. The number of Americans over 80 will triple from 2010 to 2050 and the over-90 population will increase four-fold.  He favors less government action around incentivizing or penalizing certain quality measures and more locally grown solutions."Washington can micromanage every medical act or we can create the incentives for quality care aligned toward that patient," he said. More innovation and competition and less government oversight are what's needed to improve care and reduce cost.

He likened the current set up to buying multiple car insurance policies, "one for the fender, a second for the engine, a third for the outside of the car, on and on and on and on.” He supports combining Medicare Part A and Part B and establishing an out-of pocket spending cap. He also supports a greater focus on prevention, increased patient engagement and more transparent pricing as strategies for curbing Medicare spending. 


Source: http://www.medpagetoday.com/PublicHealthPolicy/Medicare/52832