Health care spending, Medicare, workforce issues should get policymakers’ attention

Health care spending, the increase in the Medicare-eligible population, and attracting and retaining the health care workforce are among the issues that a panel of experts believe policymakers should address as the nation moves beyond the COVID-19 pandemic.

The Committee for Economic Development of The Conference Board held a webinar to break down some of the health care policy issues the nation faces now that the public health emergency is over.

The committee will release a brief on Tuesday in which it outlines its recommendations for health care policy solutions.

John Gardner, the committee’s vice president for public policy, said the committee has advocated a shift in medicine from a fee-for-service model to a payment model “that promotes cost-responsible consumer choice and private health care plans with a goal of driving the system toward quality, affordable health care for all in a more connected system.”

The committee also wants policymakers to work with the private sector or review current regulations to address shortages in the health care workforce and health care supply chains.

“The federal budget for health care programs is projected to rise by 78% over the next decade,” Gardner said. “Reforms in cost and quality of care are urgent priorities that private and public sector leaders must address to move toward a system promoting quality, affordable care for all.”

One of the committee’s recommendations includes automating the Medicaid redetermination system to ensure more accurate decisions on whether a Medicaid recipient remains eligible for coverage. “No one should receive public funding who is not entitled to it but no one who is entitled to it should be cut off because of paperwork issues,” Gardner said. “States may also wish to look in the short term for alternatives to the Medicaid unwinding and consider other pathways for coverage.”

Policymakers also must address Medicare costs, Gardner said. “Medicare Advantage offers many benefits for beneficiaries that policymakers should consider if the benchmarks can be reduced without harming enrollment or patient care. Policymakers should consider other ways to reduce Medicare costs that will not impact the quality of care. Policies encouraging the use of primary care will save money in the long run.”

The health care workforce was stretched thin during the pandemic, and attracting and retaining people to the profession continues to be a challenge.

“A greater focus on developing and retaining primary care physicians is essential,” Gardner said, “along with efforts to reach traditionally underrepresented groups, including targeted recruitment efforts and steps to encourage careers in health care early in people's education.” The committee also advocated for immigration reform to help resolve shortages as immigrants already comprise a large percentage of the U.S. health care workforce.

Policymakers should also push the public health sector and private insurers to put “greater focus on preventive care and wellness rather than simply treating problems,” Gardner said.

Health care spending is top issue

Health care spending is the top issue policymakers must address, said Dr. Ashish Jha, former White House COVID-19 response coordinator. He cited a KFF report revealing that annual family premiums for employer coverage rose 7% to nearly $24,000 in 2023.

“That is an extraordinary amount of resources for an average family in America,” he said. “We must find a strategy to deal with health care spending. For 15 years, people have been saying health care spending is not sustainable, and yet we somehow managed to sustain it. And the way we sustained it is by reducing our investments everywhere else – we’re cutting education, cutting human services.”

Jha said a broader issue facing health care in the U.S. is that 30 million Americans have no coverage.

“I really believe we can cover those people without necessarily causing a big increase in spending by making our health care system more efficient,” he said.

The Medicare tsunami

Policymakers must address the large numbers of the U.S. population who are turning 65 and becoming eligible for Medicare, a phenomenon also known as “the Medicare tsunami.”

“We must, as a nation, take a hard look at the Medicare tsunami that has been hitting our health care organizations and will continue to hit them over the next 15 years,” said Terry Shaw, president and CEO of AdventHealth. “The bubble that is coming through will demand a lot of services, and there will be no end to that for several years. And we must have a focused effort in our country to move more people into risk-based products, so that we move to a thoughtful process for outcomes – not just on a fee-for-service basis.”

Attracting more workers into health care

Shaw said the Medicare tsunami also means a greater need for health care workers.

“We're not graduating enough physicians, and we're not graduating enough nurses, to care for the people who we will have to care for, especially with the bubble that's coming through Medicare over the next 50 years,” he said. “We must radically rethink the use of nurse practitioners; we must radically rethink how we use physician assistants. There are just not enough people and the Medicare wave will stress the entire health care system in a way that we haven’t seen before.”

What we can expect from Washington

Jha said he believes “there is a large appetite to do something about health care policy in Washington. The problem is that we’re in a politically complicated moment right now.

My hope is that after the 2024 election, we will begin thinking about how we will do major reform the way we did with the Affordable Care Act. In the meantime, I believe there are incremental things we can do to expand access, to deal with costs and to improve quality of care.”

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].