Medicare’s “Rationers” – the IPAB

Joe Paduda

Posted 12/19/11 on Managed Care Matters

Among the howls of indignation coming from anti-health reform legislators and more strident Presidential aspirants one can often hear the outrage about “faceless government bureaucrats” rationing medical care to our elderly.

(we’ll leave aside that many of the howlers are the same ones screaming about out of control Federal entitlement spending…for now).

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Attacks on IPAB Gather Strength – And Waste Energy

Roger Collier

First posted 8/15/11 on Health Care Reform Update

The Washington Post reports that the Affordable Care Act’s Independent Payment Advisory Board, intended to constrain Medicare spending increases, is under increasing pressure from Republicans, health care lobbyists—and a significant number of Democrats.

As specified by the ACA, the IPAB will consist of fifteen health care “experts” to be appointed by the president and confirmed by the Senate, with authority to make cuts to Medicare if spending exceeds specified targets, starting in 2015. Congress could overrule the panel, but only by mustering a super-majority in the Senate or by creating an alternate plan to save the same amount.

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Why IPAB Is Essential

Jonathan Cohn

First posted 7/29/11 on Kaiser Health News

A little over two weeks ago, while most of you were paying attention to the debate about how to raise the debt ceiling, those of us who study health care policy were following hearings before the House Budget Committee. The purpose of the hearings was to scrutinize the Independent Payment Advisory Board, a commission that the Affordable Care Act created as part of its apparatus to control health care costs. And the hearings produced some genuinely interesting testimony on everything from the scope of the board’s authority to the limits of its legal power. If we were in the middle of a dialogue about how to improve the board’s structure and function, that testimony would be extremely useful.

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The Real Reason the Biotech Industry Opposed Medicare’s Independent Payment Advisory Board

Alison Bass

First published 6/27/11 on Alison Bass

A page-one story in The Boston Globe today spotlights the Massachusetts biotech industry’s effort to block a key piece of President Obama’s health care overhaul: the creation of an independent payment advisory board (IPAB) that would make recommendations on how to trim wasteful and counterproductive Medicare spending.

The presidentially appointed board, to be comprised of representatives from hospitals, physicians, patients, drug and device companies and other health care constituencies, is supposed to recommend program changes that will hold Medicare spending increases to levels that are no greater than the pace of economic growth (GDP) plus one percent. As Merrill Goozner explains in gooznews, the board can recommend replacing fee-for-service with bundled payments or pay-for-performance schemes. It can penalize health care organizations for lousy care and give them incentives for higher quality care. Whatever the board recommends must be passed by Congress, which also has the option of substituting its own cost-cutting measures.
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ACO Rules “Impenetrable”

Merrill Goozner

First published 4/19/11 at Gooz News

Michael Millenson, a health care consultant who many moons ago worked as I did at the Chicago Tribune, has offered a scathing critique of the Center for Medicare and Medicaid Services’ proposed rules for setting up accountable care organizations (ACOs), which are health care reform’s primary delivery system reform. Says Millenson on the Health Care Blog:

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