Long-term Medicare reform urgently needed
Lawmakers and stakeholders often rely on short-term policies that extend financial relief to help struggling suppliers and cope with growing health care staff crisis. But mostly because it’s not yet clear when the Covid public health emergency will end, I am concerned that we are at great risk of losing the forest to the trees.
Take, for example, the series of serious Medicare cuts the federal government has made to specialty services, including physical and occupational therapy. During a time of unprecedented and rising stress work costs, Medicare cuts threaten the stability of many providers, which I could ultimately harming patient access. While Congress has stepped in up to make temporary “corrections” in the past, significant cuts are still expected for the future unless long-term solutions are put in place.
In theory, Medicare cuts are supposed to save taxpayers money; but in practice, they make it difficult for older people to access the care they need. In response, lawmakers step in and pass laws to enact short-term solutions to toss the can a little later until we repeat the process only a few months later. As a result, it is extremely difficult for Medicare providers to stay afloat, adapt to the severe challenges of the workforce, and invest in expanding practices and services. The effects of temporary “solutions” are finally felt by those most in need: our patients.
However, what specialist suppliers need is a long-term sustainable solution a preserve our country’s Medicare program. In the absence of a more permanent solution, pay cuts continue to undermine providers and make it difficult for older people to access the treatments they need to heal from serious illness and injury. In this scenario, the conditions of the elderly will inevitably deteriorate, increasing the costs that could ultimately push Medicare off a tax cliff.
Is there an easy solution? No. Is it absolutely necessary to address this? Yes.
Consider the importance of early intervention as an example. Paying attention generally makes problems worse, more complex and potentially irreversible, and requires even more expensive interventions. Case in point: Physiotherapists develop unique training plans for seniors each day to help them increase strength, maintain balance, and live more independently. This is especially important after you have been hospitalized because patients tend to lose muscle mass.
But without access to therapy services, older people are more likely to suffer a debilitating slip or fall. Each year, the Centers for Disease Control and Prevention estimates that 36 million older Americans will drop, resulting in 3 million visits to the emergency room, 300,000 hip fractures, and 32,000 deaths. This not only causes tremendous pain and suffering, but is also incredibly expensive. Every year, the crashes cost the U.S. health care system, including Medicare, more than $ 50 billion. By 2030, that figure is expected to exceed $ 100 billion as more large Americans fall.
At the individual level, the data show that Medicare spending is lower for patients receiving physical therapy as their first treatment option. This underscores the enormous value of investing in specialized and preventative care solutions.
Falls represent a growing financial burden for taxpayers, so it would be wise for Medicare to invest in proven solutions to help seniors stay stable and independent safely. If Medicare continues to charge cuts to specialty providers such as physical and occupational therapists, this could force some practices to reduce the number of Medicare beneficiaries they try to stay afloat, while others may be forced to close their doors permanently.
Now is the time for Congress and Medicare to act. After years of Medicare payment cuts, U.S. specialty providers need long-term stability and a reliable reimbursement structure rather than the annual reduction in Medicare specialty payments. It’s time to dump her and move on.
As a physiotherapist, my experience shows that you can improve your health outcomes and save taxpayer money without arbitrarily reducing your reimbursement year after year.
We can’t ignore what’s just around the corner. U.S. specialty care providers are ready to work with Medicare and Congress to find the long-term solutions needed to stabilize our country’s senior care program and ensure the longevity of this vital system. The future of the U.S. elderly care system depends on this.