Chris Woodward   ( Friday, January 30, 2015


A health policy analyst thinks the Obama administration's plan to overhaul Medicare payments to doctors and hospitals is a "positive step," but she hopes more information is forthcoming.

The Obama administration wants to shift the Medicare payments it makes to hospitals and doctors so they reward quality over volume (see earlier story). Despite a slowdown in spending over the last few years, the Associated Press points out that Medicare continues to have longstanding financing problems, including a budget formula that will cut doctor payments by 21 percent in April unless Congress acts.

"The current system is broken, and I think it's a positive step that the government is trying to address this," says Hadley Heath Manning, director of health policy at the Independent Women's Forum (IWF). "I would prefer to see Congress make reforms to Medicare rather than relying on executive action for this, just because I believe there is a better solution than focusing on quality measurements."

In a market setting, Manning says consumers decide what quality means to them.

"They go to their doctor and they might be willing to pay a certain price based on what they believe is the quality of treatment that they're receiving," she poses. "Potential problems in this new model that the Department of Health and Human Services says they want to pursue … there you have a lot of questions: What will the government say is quality? How will they measure what kind of outcomes, what kind of quality treatments doctors are giving?"

The analyst goes on to point out that these same problems exist in the education world, adding that "as soon as we want to start paying teachers based on merits, the question of measurement comes up," like how do we measure what the teacher's measure is or how high or how low the quality a certain physician's treatments are?

"Hopefully more information from HHS is forthcoming so that we can have a better idea on how they intend to measure some of these things," Manning concludes.