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For Immediate Release: July 8, 1998
Contact: Rusty Jabour
Website: http://medicare.commission.gov

MEDIA ADVISORY
For Immediate Release: July 8, 1998

National Medicare Commission Details Field Hearing Schedule

Testimony to Focus on Ideas, Recommended Solutions for Medicare

WASHINGTON (July 8) - The National Bipartisan Commission on the Future of Medicare today released a detailed agenda for its national field hearing in Minneapolis next Monday, July 13. The Commissioners will tour four local health care sites that morning, and will hear several hours of public testimony at an afternoon hearing at the Minneapolis Convention Center, Commission Chairmen Sen. John Breaux (D-La.) and Rep. Bill Thomas (R-Calif.) said today.

The Chairmen said the Commission scheduled the national field hearing as part of its continuing effort to hear from American citizens about the future of Medicare.

The afternoon field hearing is open to the public, but tickets are required for admission. The tickets are free and will be available beginning at 10 a.m., Monday, July 13, outside the field hearing room at the Convention Center. General admission tickets are first-come, first-serve, based on space availability.

According to the schedule, the Commissioners will visit four health care sites on Monday morning. During those site visits, the Commissioners will see programs and discuss issues involving

• coordinated care for Medicare beneficiaries who also receive Medicaid services (dual eligibles)
• new technology and its effects on costs and quality
• health care access in rural areas (i.e. telemedicine)
• data collection to evaluate medical outcomes and cost effectiveness of treatments

At noon, the Commission will meet at the Minneapolis Convention Center for a public field hearing which will feature three panels of speakers, addressing

• the experience of private employers in purchasing health care for their employees
• managed care plans and the experience of a mature market
• education and choices for current and future Medicare beneficiaries

The afternoon session also will include two hours of audience members sharing their ideas and recommendations about improving Medicare. The Commission announced the "Call For Solutions" program on June 26 when it named Minneapolis as its field hearing site.

The 17-member Commission was created by the Congress in the Balanced Budget Act of 1997 and is charged with recommending solutions for the Medicare program by March 1, 1999, to the Congress and the Administration. Medicare is in good financial shape for about 10 years, but then the program begins to face increased demand as 77 million "Baby Boomers" begin to retire and enter the program.

National Field Hearing Details
July 13, 1998 / Minneapolis, Minnesota

MORNING TOUR SCHEDULE

8:30 - 10:30 A.M.

The National Bipartisan Commission on the Future of Medicare is working to strengthen and improve Medicare for future generations. In its work, the Commission is exploring a number of issues related to Medicare, including costs, benefits, eligibility, management and administration, and financing. On the morning of Monday, July 13, the Commissioners will tour four health care sites to learn more about programs which could offer innovations, quality and efficiency for Medicare and its beneficiaries.

The Commissioners will divide into groups to visit the four sites listed below:

1.  Topic: Coordinating financing for dual eligibles

     Site: Wilder Senior Services Clinic

     Action: Commissioners will visit a Minnesota Senior Health Options (MSHO)                         clinical site and talk with beneficiaries, contractors and program                         administrators.

The Commission, especially the Reform Task Force, has begun discussing the different sources of funding for health care services for Medicare beneficiaries. Minnesota Senior Health Options (MSHO) is a demonstration project run by the Minnesota Department for Human Services which serves dual eligibles (people who receive both Medicare and Medicaid) and combines funding from both Medicare and Medicaid. The state contracts with health care organizations that receive a capitated payment to provide Medicare and Medicaid services. The rationale is that more integrated care and reimbursement will result in better coordination and outcomes for beneficiaries. Sample topics for discussion include 1) the expected outcomes from integrating payments and care, 2) the process of obtaining waivers for demonstration projects, 3) the rationale of combining funding sources, and 4) the reasons for Minnesota's innovative health care environment.

2.  Topic: Coordinating care for dual eligibles and rural areas

     Site: Fairview University Medical Center / Mayo Clinic / rural clinic

     Action: Commissioners will tour an integrated care clinical site, observe a                         telemedicine demonstration with the Mayo clinic and a rural facility,                         and talk with providers, beneficiaries and administrators.

This visit provides a good perspective on coordinating care and financing for dual eligibles and rural communities from a provider's and beneficiary's perspective. The Fairview health system is affiliated with the University of Minnesota's academic medicine program, the National Chronic Care Consortium, and Medica's SeniorDual program. Fairview participates with Medica in MSHO and thus accepts capitated risk for dual eligibles for a full range of care, including primary, acute, and long-term care. The Mayo Health System is a network of 13 organizations providing community-based care in 54 communities in Minnesota, Iowa, and Wisconsin. The Mayo System integrates local care, often in rural communities, with specialty care at the Mayo Clinic. Sample topics for discussion include 1) the benefits of integrating care and payment for disabled and other beneficiaries, 2) the potential use of telemedicine to integrate care and increase access in rural areas, and 3) the impact of large medical group practices in rural counties.

3.    Topic: The impact of new technology on Medicare

       Site: Medtronic

       Action: Commissioners will tour Medtronic's facilities, see product                           demonstrations from local companies, and talk with local                           manufacturers, beneficiaries and providers who have used                           sample products.

Health care technology has been identified as one of the most difficult components of health care costs to predict and control. Indeed, the Commission heard Federal Reserve Board Chairman Alan Greenspan comment that medical technology tends to reduce per unit costs, but still increase overall spending. Minnesota is the birthplace of the major Class 3 Device companies like 3M, Medtronic, St. Jude, and many smaller ones. Medtronic, for example, develops and manufactures medical devices to treat cardiovascular and neurological disorders (well-known devices are their cardiac pacemakers). Sample topics for discussion include 1) the relationship between technology and health inflation, 2) the impact of Minnesota's managed care environment on the adoption of new technology, and 3) the public and private sectors' approval and reimbursement processes for new technology.

4.   Topic: Measuring quality

      Site: United Health Care Research Center / Institute for HealthCare Quality

      Action: Commissioners will tour United's facilities, view a presentation of the                         Institute's research, and talk with both companies' clinical experts.

As incentives to control costs increase and options among health plans multiply, it becomes even more important to gather and compare information on health care outcomes and quality.  United Health Care gathers and analyzes patient data to evaluate medical outcomes and cost effectiveness of treatments. For example, United demonstrated that more effective use of beta blockers prevented more serious heart attacks. The Institute for Healthcare Quality has developed an index to rank the quality of health care in each state and to assess local clinical systems. Sample topics for discussion include 1) methods for collecting data, 2) the use of clinical data for educational purposes and to improve care for beneficiaries, 3) socioeconomic and other variables which impact health outcomes, 4) the need for more outcomes data as incentives to control costs increase, 5) the limitations of available data, and 6) the role of HCFA in collecting data.

 

AFTERNOON FIELD HEARING SCHEDULE

12:00 NOON - 1:30 P.M. - Panel Discussions

Panel 1: Purchasing Coalitions -- Experience of Private Employers

During this panel, the Commissioners will hear about the Buyers Health Care Action Group (BHCAG), a coalition of 27 large, Twin-Cities-based self-insured employers, including 3M, General Mills and Honeywell. BHCAG contracts directly with 25 "care systems" which are groups of hospitals, clinics and medical practices. Sample topics for discussion include 1) how BHCAG and its providers have addressed the questions involved in the Medicare Plus Choice implementation (e.g. open enrollment, beneficiary education, employer contributions, etc.), 2) the potential for private purchasers to contract directly with providers, and 3) the effects of the coalition on quality and costs.

Speakers: Steve Wetzell, BHCAG Director; Thomas Ebert, Employers Association President/CEO; Mike Anderson, 3M Manager; and Mark Fisher, St. Croix Valley Health Care CEO

Panel 2: Managed Care Plans -- Experience of a Mature Market

Minnesota has had more experience with managed care than most states, especially in the Minneapolis/St. Paul metro area. About 40 percent of Minnesota's population is enrolled in managed care plans. In this panel, the Commissioners will hear from three major managed care / Medicare risk insurers in the Minnesota market: Blue Cross and Blue Shield of Minnesota, Health Partners and Allina. Sample topics for discussion include 1) the regional variation in utilization and the role of the private sector in lowering Minnesota's utilization rates, and 2) managed care's experience in providing care for disabled, chronically ill and other persons.

Speakers: Deborah Glass, Blue Cross and Blue Shield Vice President for Government Programs; George Halvorson, HealthPartners President and CEO; and David Strand, Allina Health System Vice President and President of Medica