A proposal from the bipartisan National Commission on Fiscal Responsibility and Reform aims to direct the CMS to establish a new payment system for physicians; increase cost-sharing in Medicare; and enact comprehensive medical malpractice liability reform to cap noneconomic and punitive damages.
In what it called the "medium term," the proposal would offset the so-called doc fix in a variety of ways, such as by paying physicians and other providers less and rewarding quality by hastening payment reforms and increasing drug rebates and by expanding cost-sharing in Medicare to promote consumer health choices and spending. For the long term, the plan seeks to contain growth in total federal health spending to the gross domestic product plus 1% after 2020 by "establishing a process to regularly evaluate cost growth and take additional steps as needed if projected savings do not materialize," according to the report.
Commission Co-chairmen Erskine Bowles, former chief of staff to President Bill Clinton, and former Sen. Alan Simpson (R-Wyo.), released the 50-page proposal, which also attempts to realize healthcare savings by expanding accountable care organizations and payment bundling; cutting Medicare payments for bad debt; placing dual-eligible individuals in Medicaid managed care; increasing nominal Medicaid co-payments; cutting federal spending on graduate and indirect medical education; and converting the federal share of Medicaid payments for long-term care into a capped allotment.
At least 14 members of the 18-member commission, which was created by President Barack Obama, must approve the recommendations before the package can be sent to Congress for action.
In a statement, the not-for-profit Committee for a Responsible Federal Budget, which focuses on educating the public about fiscal policy, called the proposal a "truly remarkable plan," saying it would cut the deficit to 2.2% of GDP by 2015; lower national debt by 60% by 2024; and balance the budget by 2037. "The co-chairs' proposal underscores the depth and breadth of reforms that must be made to the budget if we are to set the foundation for a stronger economy down the road," Maya MacGuineas, president of the committee, said in a news release. "Yes, some of these changes will be painful—there's no denying that," she added. "But we must be mindful of the consequences if we fail to act."
