Policy Paper

Making Medicare Sustainable

  • and Robert A. Berenson, Senior Fellow, Urban Institute
March 19, 2009 |

About the Collection:

The ever-growing cost of health care is the largest threat to our nation's long-term fiscal future. One way of tackling this problem is by using Medicare-the nation's largest purchaser of health care-as a catalyst for widespread efficiencies in the private sector. Medicare must become a more value-based purchaser to make the Program sustainable over time and incent the private sector toward change. It is imperative that we act decisively and soon. Yet, we believe embarking on a Medicare-only reform effort would be far less productive than comprehensive delivery system reform. Medicare buys health care from the broader delivery system. Therefore, if we fail to address our system as a whole, we will have failed to solve the Medicare Program's underlying problems. Delivery system reform must benefit all payers, patients, and providers who are willing to excel, but Medicare can and should lead the way.

Transforming Medicare is a project co-directed by Robert A. Berenson, M.D., Senior Fellow at the Urban Institute and Len M. Nichols, Ph.D., Director of the Health Policy Program at the New America Foundation. In 2006, the Project convened an Advisory Council to identify new pathways to reform Medicare's governance structure and make the Program a more value-based purchaser. In addition to Berenson and Nichols, Transforming Medicare commissioned four authors to explore Medicare's failure to become a value-based purchaser thus far and propose possible solutions. Later in 2008, the New America Foundation convened thought leaders, Members of Congress, and influential stakeholder organizations for a policy conference in Washington, DC where the contributing authors presented their initial findings. The resulting collection of papers in Making Medicare Sustainable is the culmination of the Transforming Medicare project. This expert body of work presents evidence on why Medicare must be reformed, proposes ideas for reforming Medicare's governance structure to move it toward a more value-based purchase design, and examines some possible legal impediments to reform.

Contributing Authors:

  • Richard Kronick, Ph.D., University of California at San Diego
  • Len M. Nichols, Ph.D., New America Foundation (Editor & Contributor)
  • Robert A. Berenson, M.D., Urban Institute (Editor & Contributor)
  • Tom Emswiler, New America Foundation
  • Lawrence P. Casalino, M.D., Ph.D., Weill Cornell Medical College
  • Timothy Stoltzfus Jost, J.D., Washington & Lee University, School of Law
  • Chad Boult, M.D., M.PH., M.BA., Johns Hopkins University, Bloomberg School of Public Health

For a brief synopsis of the project and the papers, please click here.

For the full text of the papers, please click here.

To read a post on Medicare reform by Dr. Berenson and Dr. Nichols on the Health Affairs blog, click here

Related Programs