THE BLOG
10/20/2014 04:48 pm ET Updated Dec 20, 2014

Making Progress in Medicare Matters

One message that is resonating loud and clear throughout this election season: Americans want answers to the major challenges facing this country, their lives and their futures. People are fatigued with political staredowns and want Democrats and Republicans to work together to develop solutions.

One of our most important domestic challenges involves the Medicare program. The problems facing Medicare, given that it involves the growing healthcare needs of more than 50 million of our most vulnerable citizens, are daunting and complex. Baby boomers are entering retirement age and becoming program beneficiaries at a rate of more than 10,000 people a day. By 2030, Medicare will cover the healthcare needs of 81 million of us. Compounding this challenge is the fact that three of every four Medicare beneficiaries suffer from multiple chronic diseases, such as diabetes, heart disease and cancer. Treatment of these chronic illnesses accounts for over 95 cents of every dollar spent by Medicare, or about half a trillion dollars every year. These escalating costs affect all of us because of the debilitating effect it has on the U.S. economy and the financial instability it brings to the Medicare program.

But with strong and focused bipartisan leadership applied to the issues at hand, there are existing opportunities to keep down overall healthcare costs. Recognized by the Congressional Budget Office, greater use of medications associated with Medicare Part D actually resulted in a decrease in other medical costs for the Medicare program. The drugs administered for a host of diseases many times actually save money by preventing more expensive acute procedures.

In their last annual report, Medicare's trustees said the program that covers hospitalizations has enough money to remain fully solvent until 2030. At that point, unless action is taken, we're looking at an unpleasant menu of policy options to keep the program afloat, such as benefit cuts, significant tax increases, or both.

Fortunately, there are actions that can and should be taken today that will make a difference:

• Medicare needs to move away from its current fee-for-service structure, in which physicians and hospitals are incentivized to order more tests and procedures, even if they aren't necessarily improving patient health. There is movement toward systems that reward health providers for better patient outcomes and continued wellness. Those efforts need to accelerate.

• We need to launch an aggressive campaign against chronic disease, an effort that will require innovation and new ideas. An important step forward will be the creation of a nationwide health data network so, for example, a patient's primary care physician and cardiologist can be looking at the same information in real time and better coordinate care.

• We need to look at efforts like those by Senate Finance Committee Chairman Ron Wyden (D-OR), who has been a longtime leader in crafting bipartisan efforts to improve Medicare, including reforming the way care is paid for and provided to patients with chronic conditions nationwide. Wyden's "Better Care, Lower Cost Act" -- which has both Democratic and Republican support -- would transition Medicare into a wellness-focused program, identifying those patients most in need and managing their care to prevent their conditions from becoming acute. It would also update medical school curricula to train new doctors on the evolving needs of the chronically ill.

• And perhaps most important, Medicare's Sustainable Growth Rate, the flawed formula that determines how much a provider receives for providing care -- and that reinforces the worst aspects of the fee-for-service model -- must be repealed immediately. In its place we need to establish a sound, sensible reimbursement system that incentivizes care coordination and proactive approaches to protecting patient health. Only then can innovations like those envisioned by Senator Wyden and others be fully implemented.

These are just a handful of important areas in which we can improve Medicare's present and future, helping preserve the program for future generations by controlling today's cost increases in a way that doesn't hurt patients, but rather saves money by enabling better health.

The great thing about the solutions we need to improve Medicare is that they're not necessarily Republican or Democratic ideas. The pathway toward a sustainable Medicare program that serves patients well is a bipartisan one, and we should embark on it sooner rather than later.