Short Takes On News & Events

For Medicare Innovations – Think Locally

By Ankita Rao

January 29th, 2013, 3:31 PM

Reforming Medicare – from changing the way doctors are paid to streamlining patient care – could benefit from a grassroots approach, according to experts and physicians at a policy summit held by National Journal Live in Washington, D.C., Tuesday.

“We need to focus more on responding to and joining local initiatives,” said Len Nichols, director of George Mason University’s Center for Health Policy Research and Ethics. As an example, he pointed to an initiative in Rochester, N.Y., that brought local doctors and hospitals together to successfully reduce hospital readmissions.

The panelists agreed that solutions to address the system’s inefficiencies should begin at the ground level with physicians, community members and patients, who could provide valuable feedback and ideas when designing new approaches to quality care and cost control.

“What the ACA has done is to set up an environment where there is support for new innovation,” said Gail Wilensky, an economist who previously directed the Medicare and Medicaid programs.

With much of the health law going into effect in 2014, the U.S. will likely see increased coverage, insurance marketplaces and an expanded Medicaid program.

But Wilensky said the health law’s limited role in changing payment models and encouraging patient engagement in the health system operations could prove to be a “fatal flaw” in what should be an overhaul of the system. “These are huge constraints in how and how fast Medicare can move,” she said.

Dr.  Edward Murphy, a professor of medicine at the Virginia Tech Carilion School of Medicine, said physicians’ attachment to the status quo was slowing down efforts to move to a system that rewards better health outcomes and lowers consumer costs. He said doctors need to adopt fundamental new practices.

“To get a broadwave movement of change across the country, it seems to me, we need a cultural shift,” he said.

4 Responses to “For Medicare Innovations – Think Locally”

  1. Bob says:

    Republicans hate Medicare. What Republicans don’t seem to understand is that we would have never needed Medicare had the private health insurance companies decided not to refuse to insure seniors. Because the private healt insurers rejected seniors seeking health insurance, Congress had to step in and invent a program that would cover their healthcare needs. Hence, they invented Medicare and it started in 1965. So, the blame for the need to invent Medicare belongs to the private health insurers because they could not make a profit by insuring seniors. If we repeal Medicare, we will return to a situation where seniors we not be able to purchase health insurance. If this happens, we will see more seniors dying earlier in life and that is exactly what Republicans want to happen. The Republican solution to reducing health care costs is to lower life expectancy.

  2. Tompkins County Health Care Task Force says:

    The Only way to save Medicare is to go to a single-payer system “Enhanced and Improved Medicare for All” Medicaid will not be needed. The ACA will soon fail because it doesn’t deal with the rising cost of health care and the low actuarial plans like the Bronze, silver and Gold will bankrupt a great number of people who use it.. Business owners will drop health care and pay the fine. Bernie

  3. Sil says:

    In response to Bob in #2 above, absolutely no one is suggesting that Medicare be eliminated, so I don’t really understand what axe you are grinding. I would agree that insurance companies have failed the US health system and consuming public, and that government intervention is necessary and inevitable. The entire Health system (all segments of the public) must be engaged as a whole, as it has been very counter productive to separate out any subset like the old or poor.

  4. Pamela says:

    This article references one provider type, representing a single professions point of view. Perhaps panels should consist of additional health care providers. Clinicians use a team approach in the delivery of health care. Not a single provider type. Being inclusive of other primary care clinisicans when creating these panels for discussion is essential to reducing cost of primary care services and expanding access to health care.

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