Medicare commission proposal and MedPAC data shape reform

A proposal for a Medicare Commission passes through the Senate Finance markup while MedPAC data may help rework Medicare spending.

CQ HealthBeat reports: "So far, a proposal to allow a new Medicare Commission to curb spending growth in the program has survived in the Senate Finance Committee's health overhaul bill — but with some important tweaks, such as allowing the commission to remain as a permanent entity."

"Republicans have expressed unease with the idea that the commission would be around for good, rather than ending in 2019 as originally envisioned. ... Similarly, the larger idea of creating a beefed-up independent body that could order Medicare spending reductions has not caught on with leading House lawmakers." But in the Finance Committee overhaul markup, the idea seems to be faring better. 

"The Finance proposal would require the commission to implement policies that reduce cost growth in Medicare by at least 1.5 percent annually beginning in 2014. If the cost growth reductions weren't met, the secretary of Health and Human Services would have the authority to make up the balance of the decrease necessary through a cumulative reduction in provider reimbursement. ... The commission is also key for the chairman's mark written by Finance Chairman Max Baucus, D-Mont., because it provides $23 billion in Medicare savings in 2015 through 2019, according to a preliminary analysis by the Congressional Budget Office" (Norman, 9/28).

In a separate article, CQ HealthBeat reports on efforts to determine what medical conditions account for the greatest levels of Medicare spending and growth and how to created new payment initiatives. "Data released by the staff of the Medicare Payment Advisory Commission earlier this month stirred excitement among commissioners about moving forward with this type of payment system. The analysis suggested that a manageable number of clinical areas accounted for a big chunk of Medicare spending. ... The findings confirmed the view of many analysts that Medicare dollars flow overwhelmingly into treatment of chronic conditions. Of the 20 types of clinical episodes, just two were acute conditions: closed fractures or dislocation of the thigh, hip and pelvis, and bacterial lung infections" (Reichard, 9/28).