The Washington Post reports today that the Obama administration is pushing hard for Congress to get out of the business of setting Medicare rates. The report notes that just before leaving the Senate, Ted Stevens engineered a permanent 35% increase in Medicare rates for Alaska providers – just the kind of pork we should oppose, and an enormous market distortion. We have a serious cost per unit issue in the US – and getting the legislature’s fingers out of Medicare fee setting would be an important step.
The Massachusetts Special Commission on Health Care Payment System issued its final report today. It’s a big document (over 70 pages), and I haven’t finished digesting it yet. The report comes down firmly in favor of global payments – and pushing the development of accountable care organizations to accept capitation or other forms of bundling of payment. The Commission recommended the establishment of an independent oversight Board to oversee the transition of payment in the state – and specified that the Board should not be comprised of stakeholders.
Today saw recommendations to take Congress out of Medicare payment rates, and have an expert independent oversight Board in Massachusetts to oversee a transition away from fee for service. Perhaps this represents a blinking light at the end of the health care reform tunnel?
Tomorrow’s Washington Post reports on the Congressional Budget Office critique of the democratic health care proposals. It’s no surprise that the CBO is taking a tough line on purported savings, and this will give fiscal conservatives pause about supporting the health care reform plan in time for a bill to pass this summer. It also gives Congress a real push to identify more savings before completing the legislation. I think that these kind of savings will require the kind of payment reform that was recommended today in Massachusetts.
