Medicare, Problem Solution
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Medicare is an essential source of healthcare coverage for the millions of the United States citizens. However, it is currently facing some serious mid- and long-term financing issues in addition to the policy challenges. The challenge from the increase in the cost of the healthcare is caused by the following:
· There are increasing numbers of the enrollees of the Medicare and therefore the cost per enrollee kept on increasing. Even though these costs have somehow reduced in the recent years, this phenomenon is uncertain going forward, long-term challenges remain.
· The rising healthcare cost per beneficiary for the Medicare is also compounded by more enrollees as a result of the aging population and the retirement of the baby boomers generation. Therefore, the current financing situation of the Medicare would be unable to sustain the program for long-term and as the time goes by, there would be an increase I the financial demands on the employers, employees, beneficiaries, and the federal budget. This would affect the policymakers who are seeking to attain a balanced federal budget (American Academy of Actuaries, 2015).
· The cost also comes from the fee for service (FFS) program which has some limitations when it comes to incorporation of the care management as well as utilization management technique which lead to the increase in the cost.
With regard to the policy problems, there are policies that are not working well as predicted by the proposers. Even after their enactment by the Congress, these policies have failed to bring changes to the Medicare system and some of them have cost a lot for this insurance coverage program. Some of the policies issues include:
· The Free-For-Service (FFS) program which was used for the traditional Medicare is paying for the volume contrary to value. Even though it permitting flexibility for the health care providers to deliver as well as for the beneficiaries to obtain some services this program has a limitation with regard to incorporation of the care management and the use of the management methods thus leading to the increase in the cost.
· Another policy that is problematic is the Medigap because it cost a lot for the Medicare healthcare coverage program. This is because it still utilizes the benefit designs through assisting some of the essential cost sharing needs that are related to the traditional FFS Medicare (American Academy of Actuaries, 2015).
· Medicare Advantage Program is also becoming problematic because previously it was meant to provide a cost-effective alternative to Medicare FFS through offering beneficiaries access to the coordinated delivery systems and care management with improved benefits. However, due to poor management, this program has become costly.
Solutions
· Medicare needs to alternate towards Affordable Care Act to help in reducing the expenditure by the Medicare, increase the Medicare revenue, and create a new health care system of delivery.
· Minimizing the cost of the conventional Medicare fee for service (FFS) plans by restructuring the physician payment system, implementing the managed healthcare methods, and revision of the benefit design of the long-established Medicare.
· Minimizing the charge of the Medicare coverage by transforming design of the benefit
· Minimizing the Medicare Advantage (MA) plan cost through amending the payment system for the aggressive building
· Reduction of the part D plan through including the proposals to minimize expenditure for prescription drugs
· Restricting the Medicare through shifting to a premium support program or the mandatory involvement in managed care
· Wide strategies to control the cost of the Medicare which can assist in reforming the benefits package to promote more cost-efficient care, concentrating on payment reform and the delivery system reforms that perfectly align the financial incentive
· There should be a revision of the FFS because currently, the beneficiaries are facing issues to do with lack of an out-of-pocket (OOP) maximum leaves beneficiaries unprotected against the risk costs.
References
American Academy of Actuaries. (2015, June). Addressing health care cost growth in Medicare: A framework. Retrieved April 2, 2018, from Examining Health Care Equation: https://pdfs.semanticscholar.org/4c54/0f3ef179029cc3dc09acd518c725e8643440.pdf