Event Recap: Second Annual Health Solutions Summit
On November 8th, the Committee for a Responsible Federal Budget hosted its second annual Health Solutions Summit in partnership with the Healthcare Markets and Regulation (HMR) Lab in the Department of Health Care Policy at Harvard Medical School. With high and rising health care costs and their impact on the federal budget over the long-term, the summit provided an opportunity to bring together experts and policymakers to discuss and explore viable policy solutions.
The event kicked off with remarks from House Budget Committee Chairman Jodey Arrington (R-TX). Representative Arrington addressed the unsustainable trajectory of the U.S. health care system and federal budget, highlighting the rapid increase of the deficit over the next ten years and the possibility that high interest rates could lead to a debt spiral. He emphasized the urgent need for bipartisan solutions to address growing concerns about the nation’s debt, promoting the idea of a bipartisan fiscal commission. Specifically on health care reforms, Representative Arrington discussed some policies from the House Fiscal Year 2024 budget resolution proposal, including the importance of site-neutral payment reforms.
Representative Jodey Arrington, Chairman of the House Budget Committee, delivered opening remarks at the Health Solutions Summit.
Next, there was a robust panel discussion on how to redesign the Medicare physician payment system. The panel, moderated by Michael Chernew of the HMR Lab, featured experts Ateev Mehrotra of Harvard Medical School, Matt Fiedler of the Brookings Institution, and Mara McDermott of Accountable for Health. Mehrotra started by noting that the time is right for comprehensive reform of the physician payment system given the pressure on Congress to address payment fixes regularly and as the Centers for Medicare and Medicaid Services looks to improve the accuracy of payments. Fiedler noted that despite current problems and physician complaints about underpayment, there has been very little change in beneficiary access over the last decade, which suggests there is room for payment rates to grow slowly without impacting access to care. McDermott elaborated on the successes of alternative payment models, which seem to expand access to patient care, improve care coordination, and lower costs. The panelists collectively agreed that the current system, including the Merit-Based Incentive Payment System is not working efficiently and potential reforms should consider the original intent to move payments away from fee-for-service to alternative payment models.
Panel on redesigning physician payment systems. From L-R: Maya McDermott, Ateev Mehrotra, Matt Fiedler, and Michael Chernew.
Two keynote speeches followed the first panel, starting with Senator Maggie Hassan (D-NH) who called for bipartisan solutions to make health care more accessible for Americans. She emphasized the need for site-neutral payment reforms to address the growing problem of hospitals charging unfair facility fees -- particularly after acquiring local physician practices -- which results in higher bills for patients. Senator Hassan highlighted her bipartisan legislation (SITE Act) to move Medicare towards site-neutral payments and promote transparency. Senator Hassan stressed the importance of ongoing advocacy for prompt progress on improving the health care system.
Senator Maggie Hassan speaks about the need for bipartisan efforts to address health care costs.
Representative Bruce Westerman (R-AR) delivered the next keynote, speaking about the critical link between health care issues and the nation's deficit, interest rates, and inflation. He called for urgency in reining in health spending and cautioned against viewing Medicare as untouchable given its trajectory towards insolvency. Representative Westerman concluded by discussing the Fair Care Act, which he has introduced in prior Congresses and takes a comprehensive approach to health care reform, borrowing some bipartisan ideas for lowering health care costs within its framework.
Representative Westerman addressed the need to tackle Medicare spending.
The event included a second panel discussion on Medicare Advantage (MA) reform moderated by Josh Gordon from the Committee for a Responsible Federal Budget, featuring Chernew and Keaton Miller from the University of Oregon. The panel discussed how reforming MA payment benchmarks is integral to reducing overall Medicare spending. Chernew explained that the MA program provides services at a lower cost than traditional fee-for-service Medicare; however, due to the design of the plan payment system and issues like coding intensity, the overall program costs the federal government more. Chernew also mentioned that long-term reform of how payments are set is necessary and that shifting to a new system could reduce waste while providing stability for provider revenues and government spending. Miller, meanwhile, presented research finding that relatively large reductions in MA payments would result in relatively modest reductions in premiums and supplemental benefits for MA beneficiaries.
Closing remarks were delivered by Christen Linke Young, Deputy Assistant to the President and Deputy Director of the Domestic Policy Council for Health and Veterans Affairs. She addressed the Administration's efforts to cut health care costs through the Inflation Reduction Act (IRA), notably through Medicare’s ability to negotiate drug prices and implement drug pricing inflation caps. She also highlighted the restructuring of Medicare Part D with caps on annual out-of-pocket expenditures and increased design efficiencies. Young emphasized the Administration's commitment to expanding IRA initiatives as a continuation of efforts to reduce health care costs. Young also put these changes in the broader context of reforms initiated by the Affordable Care Act, suggesting they have generated substantial savings for consumers and the federal government.
Christen Linke Young, Deputy Assistant to the President and Deputy Director of the Domestic Policy Council for Health and Veterans Affairs, delivered closing remarks.
The event concluded with a lively reception of policymakers, academics, and other leaders in the health care space. The Committee for a Responsible Federal Budget thanks all who participated and attended the event.