NCPA - National Center for Policy Analysis

Replacing the Independent Payment Advisory Board with Better Solutions

July 5, 2011

The Independent Payment Advisory Board (IPAB) was created by Congress as part of the Patient Protection and Affordable Care Act (PPACA) as a means of containing Medicare spending.  PPACA gives Congress a route to override the IPAB's recommendations, but it raises the bar on the legislative processes in a way that will make it difficult for Congress to intercede, says Grace-Marie Turner, president of the Galen Institute.

A number of alternate solutions are being discussed to limit the IPAB's authority or otherwise redirect its responsibilities.  A few examples:

  • Widen the baseline: IPAB could be given authority to consider overall Medicare spending, not just restrictions on pharmaceutical reimbursement and Medicare Advantage, in achieving its spending targets.
  • Break down the silos: The board could be required to evaluate the impact of its directives on overall spending, on access to care and on innovation.
  • Demonstration projects: The IPAB could be given the authority to conduct demonstration projects to move away from Medicare's outdated fee-for-service system and show the value of an integrated, coordinated care model.

The more people learn about the IPAB, the more they will insist that it be repealed and replaced with better solutions, says Turner.

Source: Grace-Marie Turner, "Repealing and Replacing IPAB with Better Solutions," Galen Institute, June 2011.

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