Sebelius: Future payments to operators will increasingly target care, accountability and savings

Sebelius spoke at the NIC 2015 Capital & Business Strategies Forum
Sebelius spoke at the NIC 2015 Capital & Business Strategies Forum

Providers can kiss fee-for-service payments goodbye, says Kathleen Sebelius.

Most recently the nation's top healthcare official, Sebelius said Medicare and Medicaid payments will increasingly be bundled, and will mandate demonstrated value as a prerequisite. Her comments came Wednesday at the NIC 2015 Capital & Business Strategies Forum in San Diego, where she also delivered a robust defense of the five-year old Affordable Care Act — colloquially known as Obamacare.

The Secretary of Health and Human Services from April 2009 through June 2014, Sebelius said the law stands as a much-needed overhaul that has expanded healthcare access, lowered costs and improved the Medicare trust fund's fiscal condition. She added that near seniors (ages 55 to 65) and seniors have greatly benefited from expanded Medicaid coverage and the creation of a new health insurance marketplace.

“Costs are coming down and quality is improving,” she told the crowd.

The law's insurance provisions have been criticized and are currently the subject of another lawsuit pending before the Supreme Court. At issue in the King vs. Burwell case is whether the law's language lets the government help all people purchase coverage.

Sebelius noted that roughly 23 million Americans have gained insurance coverage since the law went into effect. That includes nearly 12 million who enrolled through the online marketplace for individual insurance and 11 million now covered by Medicaid expansion.

Yet health inflation continues to climb at historically low levels, she noted. The Congressional Budget has lowered projections for the overall cost of implementing the law by one-third, she explained. When the measure was signed in 2010, the CBO estimated that the Medicare trust fund would be depleted by 2017. The CBO has since pushed the projection back to 2030.

Sebelius added that the new health law gives the Centers for Medicare & Medicaid Services authority to experiment with ideas that will raise care quality while lowering costs.

“That is a sea change,” she noted. She also touted an innovation center set up by CMS to do the same.

More than 1,200 people attended the National Investment Center for the Seniors Housing and Care (NIC) forum, which targets small- to mid-size post-acute and senior living operators. The event concludes Thursday.