title: A Medicare reform primer.
abstract: The use of the federal budget process to change Medicare policy is of importance to physician executives because of its impact on the health care delivery system. In particular, changes in Medicare policy, driven by the need to shore up the solvency of a politically popular program, will create changes for other public and private purchasers of health care. Reforming Medicare through the budget process is not new. Physician fees have been frozen, reduced, and selectively increased as a result. In 1983, the hospital reimbursement methodology was changed to prospective payment through this process. The budget process will continue to be used to make policy changes because of the large amount that Medicare occupies of the federal budget. Given the profound impact changes in Medicare can have in other health care sectors, the lack of consensus for a long-term solution would mean those in the health care arena will have to be prepared for significant annual policy changes through the reconciliation process.
authors.forename: G C
authors.initials: GC
authors.lastname: Benjamin
authors.forename: S A
authors.initials: SA
authors.lastname: Kennan
mesh_terms: D000368:Aged; D002017:Budgets / Q000331:legislation & jurisprudence; D004608:Eligibility Determination; D005249:Fees and Charges; D018166:Health Care Reform / Q000191:economics / Q000331:legislation & jurisprudence*; D006291:Health Policy / Q000191:economics; D006801:Humans; D007349:Insurance, Health, Reimbursement; D006278:Medicare / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D008486:Physician Executives; D014481:United States