Association for Public Policy Analysis & Management

Panel: Medicare's Future: Challenges and Opportunities

(Health Policy)

Medicare insures 54 million aged and disabled beneficiaries. Enacted in 1965, the program has evolved over-time to play a major role in health care policy in all areas of the country. Accounting for more than one-fifth of total national health care spending and an even greater share of hospital revenue, Medicare’s benefit and payment decisions influence private insurance policies as well as providing the essential platform for access and financial protection for beneficiaries. As Medicare turns 50 and baby boomers retire over the next decade there is continuing debate about its future. The marked slow-down in Medicare spending per beneficiary since 2009 following a series of policy reforms plus intensified interest in public-private partnerships to sustain slow cost growth while improving outcomes, highlight Medicare’s opportunities to make a difference as well as challenges as Medicare looks to the future. This panel will discuss key issues facing the Medicare program and opportunities to strengthen its ability to enhance access and financial security for its 54 million beneficiaries and to innovate to improve health outcome and lower costs in ways that benefit the people it covers and the nation. The panel will also examine the projected financial health of the program as baby boomers retire with options to respond to federal fiscal pressures. The panel’s chair will provide an overview of recent trends, Medicare’s central role in the US health care system and will outline key challenges and opportunities looking forward to frame the panel discussion and papers. Lead authors and panelists will then present papers on three central topics: • Modernizing Medicare’s benefits to improve access and protection for low-income and all beneficiaries; • Building on and Spreading Medicare’s role in payment innovation to support delivery system reform; and • Financing Medicare as Baby Boomers Retire Each panelist will present data drawn from the most current Medicare data-bases to provide evidence for the need for action to secure Medicare’s future and will outline potential policy option to enhance Medicare’s role looking forward. The policy options including analysis of the potential impact of illustrative reforms. The panelists will also discuss the value of Medicare as a social insurance program and the potential to use Medicare’s substantial purchasing power to stimulate broader health care system changes as policies spread and/or the benefits of positive action spill-over beyond the Medicare’s beneficiaries.