In the list of provisions included in the health care reform bills, it looks like the most important element is the Independent Payment Advisory Board, which will have the ability to set policy for Medicare.
I was just reading on the Health Beat Blog that the Independent Payment Advisory Board will be able to propose changes in Medicare payments that “will become law unless Congress enacts its own proposal to achieve the same level of cuts.” A super-majority of votes would be required in Congress to overturn the board’s decisions.
The Payment Advisory Board will be made up of physicians and health care experts. They will be able to enact changes in Medicare payment policy without dealing with the Congressional politics that have stopped changes to Medicare in the past. For example, Medicare will be able to convert successful pilot projects nationwide without waiting for Congressional approval. The Health Beat Blog says that, in the past, Medicare has launched many successful demonstration projects that improved quality and cut costs, but Medicare was not allowed to implement them without going through Congress.
Making changes in the fee-for-service payment system is supposed to be a key to cutting Medicare costs. This has been tested in many pilot projects, and the Independent Payment Advisory Board will be able to implement changes without lobbyists and special interest groups pressuring them to maintain the status quo.
This is where the action will be when it comes to Medicare changes and slowing the growth of Medicare spending.