Higher Quality Care for Medicare Beneficiaries
The President believes that Medicares most important goal is to provide enable our Nations seniors and disabled Americans with to get the high-quality, error-free health care they deserve. Physicians and other health care providers unquestionably share this goal. Unfortunately, because of benefit limitations, and inefficient and complex regulations and payment rules, the Medicare program today is not creating creates an environment for medical practice that encourages and supports high-quality care that can improve health and reduce costs provides few incentives to deliver quality care that patients need in the most efficient manner possible. Failures to provide recommended treatments, as well as frequent medical errors with serious consequences for seniors, collectively, potentially account for a large share of Medicare expenses and present an a tremendous opportunity for making Medicare beneficiaries and taxpayers better offfor improving the health of people in Medicare.
There are many examples of Medicares failures to provide high-quality care in Medicare:
Some quality problems may be greater in rural areas. For example, hospitalization rates are higher in rural areas for some chronic conditions, like angina and chronic pulmonary disease, that can usually be treated effectively outside the hospital. Rural beneficiaries are also less likely to get mammograms and recommended follow-up visits after a hospitalization.
The problems of benefit gaps, lack of coverage options, outdated management practices, and excessively complex administrative burdens undoubtedly contribute to these results. There is also increasing evidence that a range of private sector and public-private initiatives can help providers deliver better and safer care. For example, many hospitals and other health care institutions have launched collaborative efforts to use information related to quality, giving providers and patients more useful information while reducing the burden of data collection. Some health insurance systems have implemented payment incentives to encourage and reward better performance. Many of these initiatives may be particularly challenging for rural providers. For example, investments in new information systems or hiring specialized personnel may be very difficult for rural facilities with limited scopes of service and small patient volumes.
The Presidents Framework for Improving Quality of Care in Medicare
The President will work to improve the quality of care based on the following principle:
Principle #8: Medicare should encourage high-quality health care for all seniors.
All Medicare beneficiaries deserve high-quality, error-free care. To assure that beneficiaries get the most from Medicares improved benefits and coverage options:
Medicares payment system in the government plan should take steps toward rewarding better performance and encouraging investments that improve quality of care without increasing budgetary costs. Medicares risk adjustment system for private plans should reward health plans for providing appropriate care and reducing complications for chronically ill, high-cost patients without creating costly reporting burdens.
Medicare should address the additional challenges facing rural health care providers in delivering high-quality care.