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IPAB to Kick In Early to Ease Impact of Medicare Cuts

Margaret Dick Tocknell, for HealthLeaders Media, September 21, 2011

Value-based benefit design may enable IPAB to more effectively target cost sharing for those services that are most likely produce positive patient outcomes while reducing payments for services with less effective outcomes, explained Cori Uccello, the senior health fellow for the American Academy of Actuaries.

Timothy Jost, a law school professor at Washington & Lee University, and a self-described "IPAB skeptic" noted that the president's September IPAB proposals are identical to the one's he made in April. Jost, who is also the a consumer representative to the National Association of Insurance Commissioners, said that while many of the president's budget proposals seemed like reasonable ideas, he didn't want to rely on IPAB to do all of the heavy lifting for Medicare. "It's impractical. There's not much it can do from year to year other than cut provider payments." By law IPAB can't increase Medicare premiums or reduce its benefits.

Jost suggested that the Center for Medicare and Medicaid Innovation would be a better place to work on Medicare costs. "It could take a long view, experiment and find out things that actually effect healthcare over the long term."

To say that IPAB is unpopular in some circles is an understatement. Almost all Congressional Republicans and some Democrats would like nothing more than to see IPAB disappear. Objections concerning the board focus on its power, its potential to cut provider payments, and the possibility that patient access to medical care could be limited if fewer providers participate in Medicare.

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