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Medicare essential: an option to promote better care and curb spending growth

Health Affairs, 2013-05, Vol.32 (5), p.900-909 [Peer Reviewed Journal]

Copyright The People to People Health Foundation, Inc., Project HOPE May 2013 ;ISSN: 0278-2715 ;EISSN: 1544-5208 ;EISSN: 2694-233X ;DOI: 10.1377/hlthaff.2012.1203 ;PMID: 23650323

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Title:
Medicare essential: an option to promote better care and curb spending growth
Author: Davis, Karen ; Schoen, Cathy ; Guterman, Stuart
Subjects: Accountable care organizations ; Beneficiaries ; Cost control ; Cost Control - economics ; Cost Control - methods ; Cost Control - organization & administration ; Cost sharing ; Delivery of Health Care - economics ; Delivery of Health Care - organization & administration ; Design ; Drugs ; Estimates ; Financing, Government - economics ; Financing, Government - organization & administration ; Financing, Government - statistics & numerical data ; Financing, Personal - economics ; Financing, Personal - organization & administration ; Health Care Costs - statistics & numerical data ; Health care expenditures ; Health care policy ; Health Expenditures - statistics & numerical data ; Hospitals ; Humans ; Innovations ; Insurance coverage ; Insurance Coverage - economics ; Insurance Coverage - organization & administration ; Insurance, Medigap - economics ; Insurance, Medigap - statistics & numerical data ; Medical service ; Medicare ; Medicare - economics ; Medicare - organization & administration ; Physicians ; Poverty - economics ; Prescription drugs ; Prescriptions ; Primary care ; Reimbursement Mechanisms - economics ; Reimbursement Mechanisms - organization & administration ; Retirees ; Studies ; United States
Is Part Of: Health Affairs, 2013-05, Vol.32 (5), p.900-909
Description: Medicare's core benefit design reflects private insurance as of 1965, with separate coverage for hospital and physician services (and now prescription drugs) and no protection against catastrophic costs. Modernizing Medicare's benefit design to offer comprehensive benefits, financial protection, and incentives to choose high-value care could improve coverage and lower beneficiary costs. We describe a new option we call Medicare Essential, which would combine Medicare's hospital, physician, and prescription drug coverage into an integrated benefit with an annual limit on out-of-pocket expenses for covered benefits. Cost sharing would be reduced for enrollees who seek care from high-quality low-cost providers. Out-of-pocket savings from lower premiums and health care costs for a Medicare Essential enrollee could be $173 per month, compared to what an enrollee would pay with traditional Medicare, prescription drug and private supplemental coverage. Financed by a budget-neutral premium, we estimate that this new plan choice could reduce total health spending relative to current projections by $180 billion and reduce employer retiree spending by $90 billion during 2014-23. Given its potential, such an alternative should be a part of the debate over the future of Medicare.
Publisher: United States: The People to People Health Foundation, Inc., Project HOPE
Language: English
Identifier: ISSN: 0278-2715
EISSN: 1544-5208
EISSN: 2694-233X
DOI: 10.1377/hlthaff.2012.1203
PMID: 23650323
Source: MEDLINE
ProQuest Central

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Medicare essential: an option to promote better care and curb spending growth

Copyright The People to People Health Foundation, Inc., Project HOPE May 2013 ;ISSN: 0278-2715 ;EISSN: 1544-5208 ;EISSN: 2694-233X ;DOI: 10.1377/hlthaff.2012.1203 ;PMID: 23650323

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