Medicare Has Had Limited Impact Changing the Health System

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Uninsured Top Priority for Congress According to Health Care Opinion Leaders Source: The Commonwealth Fund Health Care Opinion Leaders Survey, Jan 2007.

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1 THE COMMONWEALTH FUND Uninsured Top Priority for Congress According to Health Care Opinion Leaders Source: The Commonwealth Fund Health Care Opinion.

THE COMMONWEALTH FUND Figure 1. Medicare’s Success in Achieving Major Goals “How successful has Medicare been in accomplishing each of the following specific.

THE COMMONWEALTH FUND Figure 1. Health Care Opinion Leaders: Views on Success of SCHIP Program “How successful has the SCHIP program been in accomplishing.

Virtual integration involves contractual links between HMOs and physician groups, hospitals, and other provider units. Source: How Health Care Is Organized—II:

Has a regular source of care

Percent of uninsured adults ages 19–64 Income level Race Age Firm size

Most leaders support competitive bidding for medical equipment prices and negotiation of drug prices by Medicare. “Medicare is the largest payer for health.

Adults ages 19– Uninsured now 15%

The large majority of leaders support reform options in President Obama’s budget blueprint. “The following is a list of specific policies that have recently.

Sales across state lines

Adults ages 19–64 who are uninsured or have individual coverage

Women in the U.S. Report Highest Rates of Not Getting Needed Care Because of Cost Percent of women ages 19–64 who experienced any access problem because.

Health System Performance Improvement

96% of leaders do not think 21% of GDP is an appropriate target for health care spending in “In 2009, health care will account for almost 17% of.

Net Impact of Insurance Exchange Options on Federal Budget and National Health Expenditures, 2010–2020 Option 1 Public Plan at Medicare Rates Option.

Insurance Sources for Young Adults, Ages 19–23, 2006

One-Quarter of Women in the U. S

Deductibles Have Become a Growing Factor in Underinsurance Rates

Nearly One of Three Opinion Leaders Familiar with Culture Change Believe It Has Been Effective in Improving the Quality of Care in Nursing Homes “How.

State & Local Governments

Public Plan at Medicare Rates Public Plan at Intermediate Rates

High-Need Adults Are More Likely to Be Socially Isolated

Post-Reform Role of Traditional Safety-Net Providers

Racial and ethnic differences in getting needed medical care are minimal for adults with medical homes; disparities decline substantially compared with.

Policies to Improve Care and Reduce Medicare Cost Growth

Triggering the Creation of a Public Health Insurance Plan

Physician Compensation

Percent who say “extremely successful/successful”

The Affordable Care Act and the Role of States: Provider Payment Methods “Thinking about payment and delivery system reform, do you favor a stronger role.

Strengthen Medicare Rx drug coverage Reform Medicare payment

16 Million Adults Under Age 65 Were Underinsured in 2005

Affordable Health Care Act Provisions

Reducing Medicare Advantage Payments to Match Costs in Local Areas

Adequately insured 48% Uninsured anytime 15% Uninsured anytime 36%

Reasons for Skipping Cancer Screening Tests

Major Sources of Savings Compared with Projected Spending, Net Cumulative Reduction of National Health Expenditures, 2010–2020 Dollars in billions Public.

Inadequate Coverage Is Associated with More Cost-Related Problems Getting Needed Care Percent of adults ages 19–64 who had any of four access problems.

Projected Savings and Effectiveness of System Reform Provisions in Comprehensive Reform Law 2010–19 (in billions) CBO Estimate of Budget Savings, Affordable.

Adults ages 19–64 with either marketplace or employer coverage

Payment System Options

A majority of leaders think that the SGR should be replaced with fundamental payment reform. “The Sustainable Growth Rate (SGR) mechanism is a formula.

Medicaid <133% FPL 26 million

Almost Half of Uninsured Young Adults with a Chronic Health Problem Had a Health Problem Worsen Because of Delayed Care In the past 12 months, a health.

Medical Bill Problems or Medical Debt

Only minor changes needed Fundamental changes needed

Two of Five Adults Uninsured or Underinsured 25 Million Underinsured 60 Percent Increase in Underinsured from 2003 to 2007 Percent of adults (ages 19–64)

Adults Ages 19–64 Who Are Uninsured and Underinsured, by Poverty Status, 2003 *Underinsured defined as insured all year but experienced one of the following:

Implementation of the Affordable Care Act at the State Level

Awareness and Use of Health Insurance Marketplaces by Race

Expanding the Power of the Secretary of Health and Human Services to Put Medicare Payment Pilots on “Fast Track” “How strongly would you favor or oppose.

Figure 4. Profile of Medicare Elderly Beneficiaries and Employer Coverage Nonelderly, by Poverty and Health Status, 2003 Health problems, lower income.

Consumers and Families Need Assistance in Making Informed Choices About Long-Term Care “How effective do you think each of the following strategies would.

Net savings in $ billions 2013– –2023 Total 2013–2023

Reasons for Not Enrolling in October Included Uncertainty over Affordability, Still Deciding Among Plans, and Website Technical Difficulties Can you tell.

Requiring Medicare recipients to participate in an all-payer database for research, policy development, and monitoring and evaluation purposes “How strongly.

Adults ages 19–64 who are uninsured or have individual coverage

Creation of an Independent Medicare Advisory Council

More Than Three of Five Adults Who Selected a Private Plan or Enrolled in Medicaid Were Uninsured Prior to Gaining Coverage What type of health insurance.

Patient Safety and Quality Improvement Act Judged Insufficient

Figure 9. Americans’ Overall Views of the U. S

Have you gone to this new marketplace to shop for health insurance

When Low-Income Adults Have a Medical Home and Insurance, Their Rates of Having Cost-Related Access Problems Decline Percent of adults ages 19–64 with.

Uninsured Rates Among Part-Time Students and Non-Students Ages 19–23 Are About Twice That of Full-Time Students Own-employer 7% Own- employer 26% Uninsured.

Authority of an Independent Medicare Advisory Council

Percent of adults ages 19–64 insured all year who were underinsured

Two-Year Waiting Period for Medicare Coverage for Disabled Adults

Choice of Public and Private Plan Options

All adults ages 55–64 = 29.5 million

Uninsured young adults ages 19–29 Federal Poverty Level Percent

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Medicare Has Had Limited Impact Changing the Health System “How successful has Medicare been in accomplishing each of the following specific objectives?” NET 36% 6% 5% 4% 3% Helping to decrease income and racial disparities through improved access to care and providing support for health care providers serving the poor and uninsured Using its purchasing leverage to improve the quality of care Encouraging the growth of integrated health care delivery systems and HMOs Using its purchasing leverage to control health care costs Using its purchasing leverage to promote high health system performance Source: Commonwealth Fund Health Care Opinion Leaders Survey, October 2009.