Most healthcare leaders surveyed in the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey favor sweeping Medicare changes to help control program costs and support broader healthcare reform.
The vast majority of respondents favor expanding the power of the Secretary of Health and Human Services to put Medicare payment pilot programs on a "fast track" (95 percent) and to work with private payers and providers to establish multipayer initiatives (94 percent). Similarly, there was strong support for creation of an independent Medicare advisory council (favored by 75 percent) with broad authority to collaborate in multi-payer initiatives (89 percent), develop, test, and implement payment reforms rapidly and flexibly (88 percent), and alter beneficiary incentives based on effectiveness of services, drugs, and devices (86 percent).
Among other survey findings:
- Sixty-five percent of respondents feel that bundled payments and encouraging beneficiaries to designate a medical home would be effective policies for improving care and reducing costs.
- Nearly three-quarters (74 percent) of leaders believe older adults ages 50 to 64 should be able to buy Medicare coverage.
- A strong majority (69 percent) favor having Medicare offer its own comprehensive benefit package option as an alternative to Medigap or Medicare Advantage coverage.
- Nearly all (91 percent) healthcare opinion leaders support a requirement that Medicare providers participate in developing state, regional, and national all-payer databases to aid in research, policy development, and monitoring and evaluation.
By a clear margin, opinion leaders do not favor strategies that shift costs to beneficiaries or reduce payments across the board. Only 42 percent support offering a high-deductible health plan and 36 percent approve of requiring Medicare beneficiaries to pay a higher share of costs. Capping federal spending was similarly unpopular (26 percent), as was reducing payments to providers (19 percent).
