Experts Gather to Consider Strategies for Medicare Reform


Some of the nation’s top health care policy experts and practitioners convened at Dartmouth on Monday, September 22, to discuss ways to reform Medicare, the federal insurance program for Americans age 65 and over and for younger Americans with disabilities.


Image removed. Peter Orszag, former director of the Office of Management and Budget and the Congressional Budget Office, speaks at the summit. (Photo by Mark Washburn)



Participants in The Dartmouth Summit: Medicare Reform Strategies to Create a Sustainable Health System heard from former U.S. Sen. Judd Gregg (R-NH), the former chairman of the Senate Committee on Health, Education, Labor, and Pensions and the Senate Committee on the Budget; Peter Orszag, former director of the Office of Management and Budget and the Congressional Budget Office; and former Centers for Medicare and Medicaid Services Deputy Director Jon Blum. The conference was a joint effort by Dartmouth, the Dartmouth-Hitchcock health care system, and the Campaign to Fix the Debt.

“I’m very pleased to participate in this gathering of the best and brightest thinkers in the health care sector and their commitment to find practical solutions to strengthen Medicare,” says Sen. Gregg, who is also co-chairman of the Campaign to Fix the Debt. “Today’s discussions are the first step toward legislative action that could garner bipartisan support in the upcoming Congress.”

“A key strength brought by Dartmouth in particular is in forging innovation in the spaces between traditional disciplines, where diverse interests overlap,” says President Phil Hanlon ’77. “And that’s precisely the goal of the summit—bringing together thought leaders and policy makers from across a spectrum of health care vocations and ideologies to explore these spaces between. At the very least, new perspectives were gained. But of course the real potential is for game-changing innovation.”

In addition to presentations from the speakers, summit participants joined breakout discussions to identify proposals to reduce health care costs and deliver health care more efficiently within Medicare. The goal of the summit: to produce policy solutions for the next Congress to consider.

“Reform of our Medicare system is one of the great challenges facing health care today,” says Dartmouth-Hitchcock CEO and President James N. Weinstein. “I’m impressed with level of the discussions and the commitment of all of our participants to face this challenge.”

Each of three working groups proposed a series of priorities in the areas of policy for the community, policy for those delivering health care, and policy for the individual Medicare beneficiary. Among the top recommendations: greater incentive for patient engagement, creation of policy that incentivizes the concept of shared decision making, changes in policy for the design of high-value health care, the creation of a claims clearinghouse for clinical and social service data, and revisions to supplemental Medicare restrictions.

Conference participants considered policy from many angles—policies that sometime conflict. The fee-for-service payment model incentivizes providers to supply more services than coordinating patient coverage. Patients want more time with their doctors. And an aging population means the program’s costs are projected to grow faster than the rest of the economy. Congress will have to balance these issues to protect the long-term interests of the program.

“To make any progress in fixing the debt, our elected leaders are going to have to work together to address one of its core drivers: health care spending,” says Maya MacGuineas, head of the Campaign to Fix the Debt. “We believe the diverse group of practitioners and policy experts from all spectrums of the health industry and political realm who attended the Dartmouth Summit will shed a great deal of light on where progress can be made, and that by coming up with solutions that improve delivery while reducing costs, the attendees have done a public service that will no doubt impact future discussions on Capitol Hill.”

From Monday’s discussions will come more work during the fall, refining ideas discussed at the summit and resulting in a series of legislative proposals that will be presented to Congress when it reconvenes in 2015.

“From the work at the Dartmouth Summit, we hope to inform the creation of new policy that puts us on a path to a sustainable health system,” says Weinstein. “One that not only finds new payment models, but one that will improve the lives of the people and communities we serve, for generations to come.”

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