Quality healthcare for all is a matter of national integrity, and Medicare+Choice is worthy of salvation to help preserve it, CMS Deputy Administrator Ruben King-Shaw Jr. told members of the National Committee for Quality Health Care today in Washington.
King-Shaw outlined a vision of quality that includes clinical, financial and cultural components. He described the efforts of his $427 billion agency to make improvements on all fronts.
"When something that big weighs in on quality, it makes a huge difference," King-Shaw said.
He defended President Bush's three-tier framework for Medicare reform that would provide varying degrees of outpatient prescription drug coverage currently unavailable in the program. The Bush plan places a significant emphasis on the repositioning of Medicare+Choice under the new name Medicare Advantage.
King-Shaw noted that the population that elects the Medicare managed care option traditionally suffers from chronic conditions, has low income and is disproportionately African-American and Hispanic.
Many managed care companies, however, have bolted from the program in recent years because they say federal reimbursements are too low.
Medicare+Choice could be revitalized through better financing that "recalibrates" capitation and risk adjustment to more accurately match healthcare dollars to the needs of patients, he said. King-Shaw also suggested that managed care is not the right choice for all Medicare beneficiaries.
When asked how the current administration could maintain its policy of budget neutrality for Medicare with the aging of the baby boom generation, King-Shaw said the budget would have to grow as the size of the Medicare population increases.
He predicted that the intensified interaction between that "powerful voting block" with disposable income and the healthcare system would change priorities in the next five to 10 years.
"The fundamental question is, is this country ready to rank healthcare spending or investment above some other things?" King-Shaw said. "I suspect what we currently think of as a healthcare budget will change dramatically. They'll remake it in their image."