The Centers for Medicare & Medicaid Services marked the 50th anniversary (August, 2015) of its namesake programs by recalling their start and recounting their achievements. “Here’s what we’re celebrating: more than a generation of seniors who have lived their retirements with medical care they needed without depleting their life savings,” said Andy Slavitt, acting administrator for CMS. Slavitt also noted the millions of disabled Americans and children the programs have helped. Department of Health and Human Services Secretary Sylvia Burwell joked that she had a lot in common with Medicare and Medicaid, having just turned 50 herself and having just joined social media. On a more somber note, she observed, “It is hard to imagine a world that is without Medicare and Medicaid.” In 1965, when the programs were first signed into law, seniors had to rely on their families and their savings account, and those lacking them suffered in poverty.
Poor families and children were entirely dependent on charities and providers’ goodwill. Burwell recounted how these two programs also helped close the racial divide in an era when many hospitals would not employ African American doctors or admit African American patients. “No other program has changed so many lives, our families, our friends, our neighbors, and no other program has given so many so much hope,” she said. The first week after President Lyndon B. Johnson inaugurated the Medicare program, a million people signed up. Today there are 55 million seniors and disabled Americans who receive coverage under the program, she said. More than 70 million have gained coverage through Medicaid and the Children’s Health Insurance Program, including 12.3 million Americans who joined through the provisions of the Affordable Care Act that expanded care to more low-income individuals.
Burwell also highlighted recent advances in Medicare, such as the new goal of shifting Medicare payments to focus on value rather than volume. By 2016, 85% of provider reimbursement will be paid on the basis of quality rather than the number of services provided. A second revision to the program announced this month would encourage better coordination of care during and after joint replacements by bundling reimbursement across services into one payment. Providers pay would be determined by patient outcomes following surgery and through the rehabilitation period, she explained. Following Burwell’s remarks, a panel of health industry and policy experts shared their views of the two programs and offered recommendations for the future.
Jason Furman, PhD, chairman of the Council of Economic Advisors for the White House, spoke of research that pointed to the positive economic impact of Medicaid. A study comparing low-income Americans who received Medicaid with those who didn’t found that beneficiaries, especially women, had higher wages as a result. Adults who received Medicaid coverage as children did better in school and their careers, he added. “The most plausible reason is the simplest. If you’re healthier you’re going to be more likely to graduate high school, more likely to go to college, more likely to earn more,” Furman said. “I think this fabric of our economy, from Medicaid, Medicare and the social insurance system more broadly, has all the direct moral benefits but also has an important economic set of side benefits.”
Asked what advice panel members would give to HHS moving forward, Furman said, “You’ve just got such a great platform here and the private sector really can follow your lead so take advantage of that.” Diane Rowland, ScD, executive vice president of the Kaiser Family Foundation based here, agreed that the two programs are leading the way in innovation. “Keep the people that these programs were designed to serve in mind,” she said. Although some people worried about Medicare’s financial future have called for raising the Medicare eligibility age, another speaker on the panel urged the opposite. Steven Safyer, MD, president and CEO of Montefiore Medical Center in West Chester, N.Y., said he would ask HHS to consider, in time, lowering the eligibility age. “You have huge leverage and you have the bully pulpit. So, I would say continue to move healthcare writ large with value-based purchasing and stay away from vouchers,” he said.
Tip of the Day
Popcorn is a whole grain! Pop a bag of low-fat or fat-free popcorn for a healthy snack. 3 cups equals 1 oz of grains.