The heads of the two primary Medicare advisory panels, appearing before a congressional committee, disagreed on whether the two groups should be merged this year.
Last year, Congressional Republicans moved to consolidate the Prospective Payment Assessment Commission, which advises Congress on Medicare Part A matters, and the Physician Payment Review Commission, which handles Part B issues, and to reduce their overall funding as part of a balanced-budget plan.
GOP leaders argued that Medicare's movement toward capitation eliminated the need for separate commissions and that budget savings would result from reducing the number of commissioners, staff and overhead.
But President Clinton vetoed the plan, and the two panels have been operating ever since under a series of temporary funding measures that reduced their budgets to 75% of their fiscal 1995 spending levels.
The current budgetary impasse has caused both panels to restrict their workloads.
Speaking before a House Appropriations Labor, Health and Human Services, and Education subcommittee earlier this month, PPRC Chairwoman Gail Wilensky said extending the current reduced funding would mean eliminating all work by outside analysts and reducing the number of staff analysts to 14 from 16. Analysts assess the impact of budget decisions on provider organizations. However, she added that if the two groups were merged, the budget cuts would be "much less of a problem."
However, ProPAC Chairman Stuart Altman said he did not support merging the two committees unless fundamental changes were made to the Medicare system. ProPAC, which usually has a staff of 25, now has 16 employees.
"In the current environment, (a) merger doesn't make sense," Altman said. "It is very shortsighted to merge until there are changes to the Medicare program."
But Rep. Dan Miller (R-Fla.) said the GOP would likely resubmit its merger plan in its fiscal 1997 spending plan.
"It still makes good sense," Miller said.
ProPAC requested a budget of slightly more than $3.9 million for fiscal 1997, which begins Oct. 1, while PPRC requested $4 million. Each group received about $4 million in 1995.
Sample compensation for commissioners from both panels for fiscal 1995:
Commissioner Member of Affiliation Compensation
Stuart Altman (Chairman) ProPAC Professor, Brandeis University $21,028
Clay Edmands ProPAC President, Asbury-Salina Regional
Medical Center, Salina, Kan. 8,511
Clark Kerr ProPAC President, ConsumerFirst 8,456
Joseph Newhouse PPRC Director, Division of Health Policy,
Research and Eduction, Harvard University 8,011
Giles Bole, M.D. PPRC Dean, University of Michigan medical school 7,566
Gail Wilensky (Chairwoman) PPRC Senior fellow, Project HOPE 4,450*
Richard Anderson PPRC Vice president for medical economics, Compensation
Kaiser Permanente waived
Gerald Shea ProPAC Executive assistant to the secretary-treasurer, Compensation
Wilensky began term in May 1995. Source: Prospective Payment Assessment Commission and Physician Payment Review Commission reports