Then what can be done? First, we must focus on eliminating unnecessary or ineffective care. That means preventing errors, coordinating care to avoid unneeded hospitalizations, and better managing patients with chronic conditions. We can use real comparative effectiveness research to inform treatment decisions by providers and their patients. We can use payment structures like value-based purchasing and bundled payments to reward quality, not quantity, and to reward providers for effectively working together. We can drive out the costs associated with defensive medicine by enacting liability reform that limits providers' liability when they adhere to documented best practices and standards of care.
And if necessary, we can consider ways to restructure beneficiary cost-sharing, readjust the Medicare eligibility age, and even consider increasing FICA taxes.
In the end, our problem isn't lack of options. We have plenty of them. So before we aim the financial equivalent of a blunt instrument at hospitals and other Medicare providers, we should do all we can to eliminate unneeded and ineffective care and unnecessary spending from the system. It's the best way to make real change in Medicare without compromising the care our communities need.
Michael Regier is senior vice president of legal and corporate affairs and general counsel of VHA, Inc. He can be reached at firstname.lastname@example.org.