Medicare trigger pulled again . . . yawn

So, for the third year in a row, those wild and crazy Medicare Trustees issued their report and have let us know we’re living beyond our means.

The Medicare funding warning was first triggered by the 2007 report and is triggered again with the 2008 report. The funding warning requires the President to propose legislation to respond to the issue within 15 days following the release of the next fiscal year’s budget and the Congress is required to expeditiously consider the President’s proposals. President Bush submitted legislation in February 2008 in response to the 2007 Medicare funding warning and Congress has taken no action. As a result of the new funding warning, the President must again submit to Congress proposed legislation to respond to the warning within 15 days of the release of the next fiscal year’s budget.

Yesterday’s CMS press release continues:

One possible solution is the competitive approach used for Part D where beneficiaries and their caregivers, with support from Medicare and many local partners around the country, are using information on prices and coverage to choose prescription drug plans that best fit their individual needs in terms of formulary coverage, monthly premiums, and other benefit features. Competition, together with good information on quality and price, has the potential to lead to cost savings in many other areas of Medicare as well. CMS is beginning to implement competitive reforms in durable medical equipment, Part B drug pricing, and other areas.

Additional reforms and initiatives can help address Medicare’s financial condition by shifting the program’s focus to preventing costly complications and getting the right care to each patient — rather than simply paying more for more medical services and for more complications. Such initiatives and proposals include:

• Basing payment levels on provider reports on quality and their ability to prevent costly and life-threatening hospital acquired infections;
• Providing transparent quality and cost information to beneficiaries and providers;
• Developing and testing strategies to pay more for better results rather than more services;
• Implementing competitive bidding approaches to the delivery of care;
• Promoting the adoption of interoperable health information technology;
• Implementing reductions in market basket rates of growth, as proposed in the President’s 2009 Budget, including a proposed 0.4 percent reduction in the growth rate of Medicare payments if Congress does not pass a specific alternative proposal to achieve needed improvements in sustainability; and
• Increasing the share of program costs paid by the highest-income beneficiaries, as proposed in the 2009 Budget.

We went down this path last year; as noted above, the President filed a package of proposed reforms and, you may be surprised to learn, Congress has sat on it.  Most of the proposals outlined above have been kicking around for a while, many of them are inadequate, and most of them are not yet ready for prime time.

— David Harlow