Research and data

Improving the value of medicare

improving the value of medicare

Medicare has long been a trending topic. It’s on the minds of many in the United States, and has been a cause of worry as to if the benefit all working people pay into will last long enough for them to take advantage of in their lifetime. But let’s not dwell on that right now. Instead, let’s take a look at how the Medicare program itself can improve the way its services can add value to its collective pool of beneficiaries, with equity at the forefront of its operative initiatives.

There are countless ways Medicare can achieve this. The Medicare Rights Center has outlined 30 policy goals that ought to be the focus of Medicare’s future. Among them, five that stick out immediately are:

  1. Find a way to make prescription drugs more affordable
  2. Allow for open enrollment for all people with Medicare
  3. Figure out how to employ a standard out-of-pocket maximum for Medicare beneficiary cost-sharing
  4. Ease access to enable better engagement with low-income assistance programs
  5. Establish equity between Medicare Advantage and Original Medicare, allowing access to all services for beneficiaries

Equity is at the heart of improving the value of Medicare across the board here. Establishing equal accessibility to the program’s members is vital to public health now, and in the future. Our colleague, Austin Frakt, Professor of Health Law, Policy & Management at BUSPH, recently wrote an article in his The New York Times column, Upshot, entitled, “Drug Prices by Committee: One Way Biden Could Lower Costs.” As it stands, the cost of prescription drugs in our country is always a hotly debated topic, being that the United States is generally known for having the most expensive drug prices in the world. And we’re not talking a little bit more expensive either… The reality is, the cost of prescription drugs is 2.56 times higher than other countries. That number jumps to 3.44 times higher for name-brand prescription drugs.

Those numbers make it clear that finding a way to make prescription drugs more affordable should be at the top of the list for helping to improve the value of Medicare, and for more general access to care.

With that said, Frakt’s piece looks at the cost of prescription drugs and what drives those costs up so much. Sure, there’s profit at the forefront of everyone’s mind, and often, we associate profit with someone lining their pockets with riches. But it’s also important to note that with profit comes innovation — the reinvestment of profits to drive studies and research that can potentially lead to bolstered human health with more beneficial innovative discoveries. So, there’s a balance that needs to be found.

Of course, there’s far more to figure out where the right places are to increase the value of Medicare. The spotlight is often pointed at healthcare facilities and drawing attention to the quality of care received in correlation to healthcare pricing. It’s a loaded topic, to be certain.

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Here’s an interesting video — part of the “Healthcare Triage” series — that explores the topic of how improving Medicare has found some successes, but also, some slow climbs to show improvement in quality and value overall. The episode itself (as you’ll hear right out of the gate) was written and created as a direct result of Dr. Frakt’s Upshot piece. In a nutshell, the topic at hand is a continuous ebb and flow that positions innovation and affordability on opposite sides of the proverbial rope.

So how can we continue to figure out ways of improving the value of Medicare and affording better public health initiatives as we push forward? It’s a difficult and critical question. If you have an idea, we’d love to learn more about it!

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