Medicare needs a repair -- not a radical overhaul, according to a two-year study by an expert panel for the National Academy of Social Insurance, Washington, a not-for-profit think tank focusing on Medicare, Social Security and other such programs.
Despite finding "no compelling need for a radical overhaul of Medicare's governance," the panel said in a report that the program suffers from poor management, insufficient resources, outdated information systems and bureaucratic errors. In fact, those shortcomings have reached a "critical level," the panel said.
Chief among Medicare's problems is inadequate funding for its growing responsibilities. "Medicare must have more money for the heavy burden of administering such a complex program, including processing a staggering load of nearly 1 billion claims a year, communicating with beneficiaries and writing regulations for Medicare's payments to more than 6,000 hospitals," the institute said in connection with the report's release.
Still, the expert panel "did not come to the consensus that (Medicare's) current form of governance is fatally flawed," the institute's director of health policy studies, Kathleen King, told Modern Healthcare's Daily Dose.
The 13 panelists included Gail Wilensky, former administrator of what was then called HCFA, now the CMS, and former American Medical Association President Thomas Reardon, M.D.
The report includes 12 recommendations to improve Medicare. Some of them are:
* Immediate action on the CMS' management and administrative problems, regardless of whether Congress takes broader action on Medicare;
* More funding without further expansion of responsibilities;
* Freedom from functions not directly related to Medicare and Medicaid;
* Some relief from salary and civil service rules to aid recruiting; and
* More flexibility to contract for claims processing.
Click here for the full report.