"All of these models are based on lag indicators adjusted going forward. The future of healthcare can't be predicted based on lag indicators. You can't bet that historic visits, tests, and discharges are a basis for the future because that model is not sustainable."
A lot of heat is expected to be generated by the trustees' report on the campaign trail but Gorman says there won't be any meaningful Medicare initiatives until after the November elections.
Congress in 2013 will likely examine in more detail the Medicare reforms brought forward by Rep. Paul Ryan, R-WI, and Sen. Ron Wyden, D-OR, as well as further discussions of once-taboo cost saving measures such as raising the Medicare eligibility age, and means testing for wealthier beneficiaries.
"We are going to see the big reveal on where Medicare reforms' prospects lie next year in the deficit control debate," he says. "You couldn't have spoken about those things a few years ago, and now they are part of the firmament of the discussion and that is all positive."
"At the end of the day, the only thing that will extend the life of Medicare past the next decade is structural reform that deals with beneficiaries' demographics and their true needs with the program, the ability to bend the curve on chronic illnesses that contribute most to the increases in spending in Medicare every year, and there has to be use of capitation in the Medicare program if you want to have stability in the budget."