Nearly 60 million elderly and disabled people count on Medicare for health care coverage. Without the program, they and their families could be responsible for billions of dollars of health care costs.
Medicare spent about $700 billion in 2017 and this amount is expected to grow substantially over time because the population is aging and health care costs are rising. What does that mean for Medicare’s long-term financial health? The video below shows the results of a “check-up” of the Medicare program based on findings from the Medicare Trustees’ June 2018 report and previous GAO work.
What can be done to improve Medicare’s financial health?
Further actions to ensure the program’s integrity and reduce improper payments could help. For example, we’ve recommended that the Centers for Medicare & Medicaid Services improve its audit process and help prevent improper payments by requiring prior authorization for certain services and taking steps to review claims more thoroughly before payments are made.
We have also highlighted the need for continued payment reform—how Medicare pays hospitals, doctors and other medical providers and rewards them for quality care. For example, we recently recommended that Medicare change the way it pays for certain hospital inpatient and outpatient services to ensure that the program does not overspend for these services. In addition, Medicare has begun to transition from paying providers for the volume of services provided to paying for the quality and efficiency of care. As CMS makes this change, it will need to continue considering how to best measure the quality of care patients receive and how to better align health quality measures across public and private payers.
To learn more about the challenges facing Medicare, our recommendations to help, as well as our key reports on the issue, check out our Medicare High Risk area.