Ideas for Improving IPAB
As our readers know, CRFB is a big proponent of the Independent Payment Advisory Board (IPAB) created under health reform to control Medicare cost growth. In the health care paper from our Let's Get Specific series, we suggested potential ways to strengthen IPAB. Today, Ezra Klein offered some more good ideas for how to improve IPAB in his blog:
1) Right now, its mandate is to lower costs through the system. The agency should be similarly focused on quality. Quality is important, and it matters for both the rich and the poor.
2) Hospitals are exempt till 2018. They shouldn’t be.
3) The IPAB should have the same powers in Medicaid that it does in Medicare, and it should at least have an advisory role in the exchanges.
4) Right now, the IPAB is limited to reforming how and how much providers are paid. It’s not allowed to make reforms that “ration” care, that change benefit design, or that change the amount or structure of premiums and cost sharing. Those strictures should be removed. The president’s budget, which would allow IPAB to venture into designing value-based insurance packages, is a good first step, but it’s not enough.