Some Medicare Experiments

Medicare regularly tests different ways to provide and pay for care. It’s becoming more creative and inventive than in the past. This article describes a series of test programs underway around the country, including one that pays for basic life needs that aren’t directly related to health care. If they produce results, they could become part of the full Medicare program.

The program could provide valuable lessons for the $700 billion Medicare system overall as it prepares for the aging of the baby boom generation, which will nearly double the population it covers over the next two decades. The Medicare trust fund that pays the hospital and doctor bills of most Americans over 65 is already approaching insolvency; current projections show it running out of money in 2026, which could force radical cuts in benefits if it doesn’t find a way to deliver more affordable care.

So far, only a handful of Medicare- and Medicaid-funded plans are running demonstration projects like the one for Chadwick. But starting next year, Medicare’s managed-care program, Medicare Advantage, will experiment with these ideas on a far larger scale, for the first time possibly covering some non-medical health-related services for patients, such as home-delivered meals. And as government moves away from the traditional “fee-for-service” system that reimburses doctors for appointments and procedures, and instead adopts payment models designed to reward providers for keeping patients healthy, the lessons Commonwealth Care has learned could provide the template for the Medicare program of the future.