How Good is the Quality of Care in Medicare?

The federal government’s responsibility to provide access to health care for the nation’s 41 million Medicare beneficiaries implies another obligation: to spend taxpayer dollars wisely. This means assuring that the $250 billion+ spent for Medicare goes for services that are safe, timely and effective.

How well is the Medicare program meeting these goals? Why is there an inverse relationship between how much is spent per Medicare beneficiaries across the states and the quality of care rankings for those states? Why are there unexplained variations in care at the end of life? What is the relationship between staffing levels and quality? What should be done to boost the quality of care for Medicare beneficiaries while assuring the most effective use of resouces?

To explain the wealth of data on this subject and highlight important trends, the Alliance for Health Reform and The Commonwealth Fund co-sponsored a May 6, 2005 briefing. The focus was on the care for the elderly living in the community. Panelists were: Glenn Hackbarth, chairman of the Medicare Payment Advisory Commission; Sheila Leatherman and Douglas McCarthy, co-authors of Quality of Health Care for Medicare Beneficiaries: A Chartbook (released by The Commonwealth Fund the day of this briefing); John Rother, director of policy and strategy at AARP; and Christine Cassel, president of the American Board of Internal Medicine. Anne-Marie Audet of The Commonwealth Fund made opening remarks, and Ed Howard of the Alliance for Health Reform moderated. A CD-ROM version of the chartbook was available to those attending. (Sheila Leatherman is a research professor in the School of Public Health at the University of North Carolina, Chapel Hill. Co-author Douglas McCarthy is president of Issues Research, Inc., in Durango, Colorado.)

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