The future of Medicare policy reform.
The Medicare program, the largest health insurance program in the United States, is clearly at a crossroads as it enters its third decade. Historical increases in health care expenditures, plus a changing political and economic landscape, have set the groundwork for policy reform. Two basic reform strategies--reimbursement arrangements and program funding mechanisms--are discussed. In 1983, Congress enacted the Prospective Payment System (PPS) which initiated a fundamental change in the way hospitals are paid for care delivered to Medicare beneficiaries. But the PPS is only a stepping-stone to broader reforms such as capitation. In addition, new methods of program funding may be necessary, especially in light of policymakers' considerations of coverage of services such as long-term care and organ transplants.
Dobson
A
A
Health Care Financing Administration, U.S. Department of Health and Human Services Baltimore, MD 21207.
Langenbrunner
J C
JC
D005381:Financing, Organized; D005544:Forecasting; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence; D011445:Prospective Payment System / Q000191:economics; D014481:United States