Date: July 1st, 2011
An IPAB is not the latest device created by Apple to play music or store your online files. IPAB is the Independent Payment Advisory Board and its purpose is to oversee costs in Medicare. The only similarity between IPAB and an iPAD is that both are small and complex units with tremendous power to change lives. But for those receiving their health care under the Medicare program, IPAB’s changes may not be for the better.
The IPAB was part of the sweeping health reform bill that was signed into law last year. The bill requires the IPAB to make cuts to parts of the Medicare program for every year that Medicare costs increase by a specified amount. It’s a 15-member board appointed by the President that will have the authority to make major decisions about Medicare with little accountability.
Beginning in 2014, the IPAB is expected to propose Medicare cuts to the President and Congress. Its recommendations will automatically become law unless Congress is able to override them with their own proposal that will produce equal cost savings. Recommendations made by the IPAB cannot be considered in Federal courts and they will not have oversight from the Department of Health and Human Services. They also will make these decisions through a process that doesn’t allow patients to challenge their recommendations. In effect, the IPAB will have the power to write health care laws without the involvement of an elected official or the public. Most concerning is that IPAB can also undo important protections in current law.
What IPAB Means for You
Seniors will be the most affected by any cuts to the Medicare program recommended by the IPAB. The health reform bill that created this board received support from more than 100 organizations representing senior’s interests because of the importance it placed on improving efficiency and coordination of care in the United States. However, there was almost immediate concern among many of these groups about how the IPAB’s structure and mission would affect older Americans’ access to the best doctors and limit their choices of necessary treatments and services.
Because the IPAB’s aim is to come up with savings in one-year periods, their focus in the near term will be to target areas that can achieve immediate reductions. This could include cutting the rates that Medicare pays for medical procedures and drugs. It could also include refusing Medicare coverage for costlier treatments. A short-sighted strategy like this will not favor access to medications or services that benefit patients in the longer-term by delaying the onset of debilitating diseases or helping to avoid unnecessary care in the future. This longer-term vision is more important now than ever before in a world where people are benefiting from longer lifespans but facing more chronic diseases.
The IPAB also has authority to dramatically cut Medicare payments to those providing services to seniors. The Center for Medicare and Medicaid Services has even expressed concern that physicians and other health care providers might leave the Medicare program as a result of further cuts. Recent studies have shown that many doctors already limit the number of Medicare patients they see because payment rates are low. The concern is that this problem will grow and soon patients won’t be able to find a Medicare doctor at all. Isn’t that especially problematic at a time when older adults are making up the fastest growing segment of the population?
What You Can Do
The health reform bill established several promising avenues to improve the health care system. Models like the patient-centered medical home and health innovation zones have been shown on a smaller scale to save substantial amounts of money. These and other solutions are just beginning to be expanded nationally and they have the potential to reduce costs without sacrificing access or quality. We believe that these models appropriately value the role of medical technologies and support a longer-term vision of how care should be delivered to older American’s.IPAB’s focus should also be on better ways to pay for and deliver care to seniors.
Some in Congress are moving forward with plans to repeal the IPAB. In the absence of a repeal, there are still some possible solutions. One is to give patients a stronger voice and a role in determining the IPAB’s recommendations through public meetings, national forums, and open comment periods. Another is to increase the role of Congress in modifying or rejecting the IPAB’s recommendations.
The Alliance for Aging Research is working with other organizations who supported the health reform bill to ensure that changes to the health care system in the United States still allow us continue to meet the growing treatment needs of older Americans. Now is the time to have your voice heard. Get on your iPAD or pick up your phone to contact your Congressperson and let them know that the IPAB in its current form does not serve the best interest of seniors.