The Medicare Payment Advisory Commission, in its June report to Congress, outlined a number of proposals that, if implemented, could change how doctors are trained in the classroom, how they treat patients at the bedside and trim back Medicare payments for certain sectors in an effort to save money and streamline care.
Costs are high and increasing at an unsustainable rate in part because the healthcare delivery system we see today is not a true system: care coordination is rare, specialist care is favored over primary care, and quality of care is often poor, the MedPAC report stated.
One proposal, aimed at reaching doctors in training, would focus educational efforts away from a model focused on acute illness and instead toward one that values patient-centered care. Medicare spent more than $9 billion in 2008 on graduate medical education while MedPAC found that too often, schools do a poor job of training doctors to work across disciplines and to judge cost and quality.
Still more options examine ways Medicare can lower its annual payments to the private plans under Medicare Advantage, better coordinate care for the chronically sick and amend the way it pays for supplemental insurance.