On March 4, President Barack Obama unveiled his proposed $3.9 trillion FY2015 budget. The budget provides "big picture" of the president's priorities. Congress and the White House will need to agree on a budget by Sept. 30, the end of the 2014 fiscal year, which may be difficult given the limited election year work schedule and continued partisan fighting. The budget will nonetheless inform discussions among House and Senate leaders.
Replicating the budget the president proposed a year ago, the latest proposals call for home health copay, a 1.1 percentage point reduction in each year's inflation updates from 2015 through 2024 and a proposal to establish a permanent, voluntary bundled payment program for post-acute providers (including home health) beginning in 2019.
Home health savings could help pay the cost of replacing Medicare's sustainable growth rate (SGR) formula for paying physicians, now $138.4 billion over the 11 years through 2024, according to the latest Congressional Budget Office estimate.
The president's budget highlights his desire to adjust payment updates for post-acute providers; incentivize bundled payments; expand value based purchasing; link payment to quality of care in additional settings; establish a home health copayment for new beneficiaries in 2018; and implement new waste, fraud and abuse initiatives.
The budget also includes proposals to:
- Better align payments to rural providers with the cost of care.
- Strengthen quality incentives and reduce the risk of prescription drug abuse in the Medicare Part D program.
- Make other modifications for new beneficiaries starting in 2018, such a modified Part B deductible.
- Create a budget-neutral pilot in a limited number of States to provide services to qualifying low-income adults under age 55 through the Program for All-Inclusive Care for the Elderly (PACE). Pilots will test whether PACE programs can effectively serve a younger population without increasing costs.
To read the president's budget proposal click here.