For Immediate Release
Contact:
John M. Martino
Phone Number: (215) 895-1186
Date: 07/01/01
WHAT
DOES MEDICARE AGENCY NAME CHANGE MEAN?
As
Medicare celebrates its 35th birthday on July 1, the agency
that runs both it and the Medicaid program has received a present from
the Bush administration - a new name. The Health Care Financing Administration (HCFA), which provides
health care to 70 million Americans, will now be known as the Centers
for Medicare and Medicaid Services. Why the change? Dr. Robert Field, director of the health policy program at
University of the Sciences in Philadelphia, says the rationale is to create
a new image for an agency that has taken its lumps from providers and
patients throughout the years. The
newly named agency will have three main divisions:
one that will run the Medicare program, one that will run the Medicaid
program, and one that will oversee new approaches, such as managed care.
"There's
been an effort for several years to offer managed care, specifically private
HMOs, to Medicare beneficiaries as an alternative to the traditional 'fee-for-service'
program," says Field. "The
theory is that this would spawn competition among HMOs, which would raise
quality and control costs."
This
theory was imbedded in the 1997 Medicare+Choices Program, which allowed
beneficiaries to receive their benefits from an array of private HMO options.
However, that program has so far been unsuccessful because many
HMOs believe the reimbursements are too low to make providing coverage
affordable. Dr. Field says
the Bush administration will make "a big push" to include this approach
in its health care agenda, and the agency name change is part of it.
"The
Bush administration says it wants to have 30 percent of elderly patients
in managed care by the year 2005," says Field.
"It will be a difficult sell, though.
While funding for HMOs has grown somewhat, it is not clear that
the market is lucrative enough for them to want to stay in it."
HMOs
were also proposed as a health care solution when former First Lady Hillary
Clinton introduced her health plan on 1993.
"There is a great irony in all this," Field says.
"The theoretical foundation for having seniors choose between competing
HMOs is the same as that of the ill-fated Clinton plan.
But that plan was presented as a 'cure all' for the entire health
care system, while Bush's goal is more limited.
The expectations are far less grandiose so they may be more reasonable."
"Maybe
in the long run, this is the right way to reform health care," noted Field.
"By using competing HMOs for just the Medicare portion of the population
before applying it to everyone we can try to get the kinks out."
But he added that it's too early to tell right now.
"There are so many issues that have to be addressed, including
the question of how to fund the plan."
Nevertheless,
Field believes that the HMO idea is not likely to go away any time soon.
"Any approach favored by both Hillary Clinton and George W. Bush
has got to have some staying power," he observed.
To
arrange an interview with Dr. Field, contact John M. Martino at (215)
895-1186 or e-mail at j.martin@usip.edu.
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