McCaskill, local health leaders look for ways to improve Medicare

Aug. 01--Sen. Claire McCaskill sees Medicare as an essential government program, but one that needs improvement.

So on Friday, at a hearing at the Five Star Senior Center in St. Louis, Missouri's senior senator asked key health care leaders for recommendations to make the government-run health insurance program for the elderly run more efficiently.

Right now, McCaskill said, the different parts of the Medicare program that cover hospitalization, prescription drugs and doctors visits operate in "silos," and that results in a fragmented system that's difficult for patients to navigate.

She called for "blurring the lines" to make the program function more smoothly, improving the delivery of services while saving money.

In 2014, Medicare spending amounted to 14 percent of the federal budget, according to the Kaiser Family Foundation.

One way to address fragmentation in the Medicare program, Sandra Van Trease, group president of BJC HealthCare, told McCaskill is to expand the use of Accountable Care Organizations, or ACOs.

ACOs are a disparate group of health care providers that come together, in response to payment incentives from the federal government, to provide the most appropriate care.

McCaskill, a Democrat, said she wants to take the best practices BJC HealthCare has learned through the ACO demonstration and integrate them into the entire Medicare program.

During the hearing, McCaskill expressed concern that Medicare wasn't adapting quickly enough to utilize what's being learned through the ACOs, or incentivizing these types of programs enough.

"I don't think they're being shared broadly enough, quickly enough," McCaskill said.

Due to seniors' limited access to transportation, it would make sense to use telemedicine more broadly, Van Trease said. But there's "minimal reimbursement" for telemedicine and that's "challenging when caring for numerous individuals in rural communities," she added.

Other experts also addressed problems with Medicare Part D, the program that covers the cost of drugs.

Brit Prim, vice president and general manager of government programs for Express Scripts, advocated for more controls to crack down on fraud, waste and abuse under the Medicare Part D program. He also addressed the problem with the unsustainable and rising price of specialty medications like those used to treat Hepatitis C.

There are about 1 million Medicare recipients in the state of Missouri and more than 49 million across the country, according to 2012 data with the Kaiser Family Foundation.

During the hearing, McCaskill repeatedly cited her late mother, Betty Anne Ward McCaskill, as an example to explain her own insights and frustrations with the program.

"I saw her struggling with the doctors, and the doctors' appointments, and the emergency room visits, and the medicine and whether or not we could get therapy at home," McCaskill said.

Samantha Liss -- 314-340-8017

@samanthann on Twitter

sliss@post-dispatch.com

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