Challenges for Medicare at 50

• Published in: The New England journal of medicine Vol. 373; no. 21; pp. 1993 - 1995
• Main Authors: Ginsburg, Paul B, Rivlin, Alice M
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 19.11.2015
• Subjects: Accountable care organizations; Health care expenditures; Health care policy; Health Care Reform; History, 20th Century; History, 21st Century; Hospitals; Length of Stay - trends; Medicaid; Medicare; Medicare - economics; Medicare - history; Medicare - legislation & jurisprudence; Patient Protection and Affordable Care Act; Payment systems; Physicians; Prospective Payment System; Reimbursement Mechanisms - history; United States; United States; United States > US
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMp1511272

By accelerating adoption of provider-payment reforms in the traditional program and increasing competition under Medicare Advantage, Medicare could achieve better results and move the health care system toward higher quality and sustainable costs. Medicare will be under huge pressure in the next few years from the demographic bulge and rising per-enrollee spending. We see this challenge as an opportunity for the program to take more aggressive action to improve care delivery. As the largest payer for most U.S. health care providers, Medicare has the potential to improve the quality and efficiency of U.S. health care delivery overall — but it hasn't used this clout effectively in recent years. As the participants in a recent conference that we organized on “Strengthening Medicare for 2030” 1 concluded, Medicare would be wise to accelerate the adoption of . . .