To examine key questions regarding Medicare's future structure and financing and ways to improve the program, the AARP Public Policy Institute conducted off-the-record interviews with 20 nationally recognized health policy experts about how to improve the cost, access and/or quality of the Medicare program.
The experts identified a number of potential improvements for Medicare's fee-for-service program, including:
- Expanding care coordination
- Restructuring benefits
- Reducing waste of resources
- Adopting new approaches to purchasing
- Addressing long-term funding issues
- Streamlining congressional oversight
- Focusing on evidence-based medicine and assessment of health care technologies and practices
While disagreeing with each other about the overall directions in which they would like to see the program go, most of the experts agreed there is little "low-hanging fruit" to be picked or “silver bullets” in terms of cost controls which would be likely to dramatically slow Medicare spending, at least in the short term. Many of the suggested tools have been available for some time but are not being used effectively due to political limitations and/or budget constraints.
Interviews were conducted from June through August 2006 with selected individuals whose expertise and views might counter-balance each other. In as this is not a random survey, its findings should not be considered representative of the views of all health policy experts. (28 pages)