The Congressional Budget Office (CBO) recently released a 235 page report entitled "Budget Options, Volume I, Health Care."

In the report, the CBO presents 115 options for reducing (or, in some cases, increasing) Federal spending on health care, altering Federal health care programs, and making substantive changes to the nation's health insurance system. However, the CBO makes no recommendations in the report. 

Nevertheless, the CBO report identifies and discusses numerous options for the Medicare program.  In brief, the options pertaining to the Medicare program include (but are not limited to):

• Bundling payments for hospital care and post-acute care
• Reducing Medicare payments to hospitals with high readmission rates
• Allowing physicians to form bonus-eligible organizations and receive performance-based payments
• Paying primary care physicians in Medicare using a partial-capitation system with bonuses and penalties
• Paying for a medical home for chronically ill beneficiaries in fee-for-service Medicare
• Requiring prior authorization for imaging services under Medicare
• Requiring drug and device manufacturers to disclose their relationships with physicians who participate in Medicare
• Creating incentives in Medicare for the adoption of health information technology
• Requiring the use of health information technology as a condition of participation in Medicare
• Reducing Medicare's fees for physicians in areas with unusually high spending
• Reducing Medicare's payment rates for hospitals in areas with a high volume of elective admissions
• Eliminating inflation-related updates to Medicare's payment rates for home health care for 5 years
• Reducing the update factors by 1 percentage point for: hospital inpatient operating payments; payments to providers for post-acute care; and/or payments to skilled nursing facilities
• Modifying the sustainable growth rate formula for updating Medicare's physician payment rates
• Requiring a copayment for home health episodes covered by Medicare
• Eliminating the "doughnut hole" in Medicare's drug benefit design
• Reducing Medicare payment rates for primary care physicians who do not meet benchmarks for influenza vaccination

For additional information, see the CBO's report entitled "Budget Options, Volume I, Health Care."

MEDVAL 1-888-SET-ASIDE
Medicare Set-Aside Allocation/Arrangement Recommendations
Submissions to Centers for Medicare and Medicaid Services
Post-Settlement Administration
Pharmacy Benefit Management