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The Solution Is Medicare Payment Reform
Medicare, the nation's largest health entitlement, is badly broken. Medicare's legacy costs are hauntingly similar to those that helped topple the U.S. auto industry. Before adding more public programs, Congress should reform the Medicare payment system to improve health care delivery.
The current Medicare program has many flaws. The quality of care across the nation is uneven and Medicare expenditures have no consistent relation to outcomes. Medicare heavily rewards procedures and technology, which are often not cost-effective. It does not pay for coordination of care for its most complex and expensive patients
Everyone on the front lines sees the consequences. Patient care is fragmented, leaving the elderly and their families trapped in a confusing maze of multiple doctors, hospitals, extended care facilities and pharmacies. Primary care physicians are challenged by the growing burden of chronic disease in our aging population. Such care requires time and resources, neither of which is rewarded by the current payment system. As a result, young doctors are no longer interested in primary care careers at a time when the need for such physicians has become acute.
The solution is Medicare payment reform, a fact well known on Capitol Hill. The most transformative would be payment that aligns physicians and hospitals to take joint responsibility for the cost and quality of health care. Many of us in group practice have experience with such arrangements and have seen that organized systems of care can deliver value. Medicare should use its leverage to promote such a model of practice. Otherwise, the present fragmentation of care will continue to waste resources, increase costs and threaten advances in quality.
Medicare is heath care's "lead dog," setting the pace for the rest of the industry. If Medicare cannot stimulate change by redesigning its payment system, dreams of health-care reform will remain a fantasy.
By
Mark Kelley
|
June 7, 2009; 4:09 PM ET
| Category:
Health Care Reform
,
Medicare
,
Primary Care
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Posted by: STANTONCAROL | June 14, 2009 8:37 AM
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Dr. Kelley is right on! He identifies the two keys for controlling our country's health care costs, beginning with Medicare, but he has them in reverse order of priority - re-structuring how care is delivered must be agreed upon first and then a reformed payment methodology must support it. Dr. Kelley correctly notes and laments the fragmented system of delivering care. He is right on target in stating that physicians and hospitals need to take joint responsibility for delivering quality, cost-effective care. Payment reform that recognizes coordination of care, as well as the other attributes Dr. Kelley notes, is essential to make it happen. These ingredients are at the core of health care reform. Special interests should not be permitted to delay us in doing what needs to be done!
Posted by: jtkerr | June 10, 2009 9:52 AM
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Finally someone who is a voice of reason speaks out about our current health care system and the importance of reforming one of the largest government run health care providers which is Medicare. Medicare and Medicaid/Medical should be the first programs reformed before the government changes or overhauls our nation's entire health care system. Anyone who works as a professional in the health care industry is well of aware of the flawed payment plan or reimbursement of Medicare and Medicaid. It is vital and equally important that physicians as well other health care providers be included in the decisions of changing our health care system especially with the roles that each of these individuals play in a patients care. Who better understands a patients condition, treatment and care than those who working directly with the them?
Posted by: Rhonda5 | June 9, 2009 10:59 AM
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do not side with big business and the insurance companies and pers drug companies.....side with the AMERICAN PEOPLE AND BARACK OBAMA .........THAT IS THE REASON HE WAS ELECTED...WHEN IT COMES TO HEALTHCARE IN OUR COUNTRY.