Independent payment advisory board's future questioned

(HealthDay)—Established as a part of the efforts of Affordable Care Act (ACA) to contain health care costs, the Independent Payment Advisory Board (IPAB) has been surrounded by controversy, and still has no members, according to a perspective piece published online May 29 in the New England Journal of Medicine.

Jonathan Oberlander, Ph.D., and Marisa Morrison, from the University of North Carolina at Chapel Hill, discuss the controversies surrounding the IPAB and its role, with particular reference to its ability to recommend changes to Medicare if projected per-beneficiary spending growth exceeds specified targets.

According to the authors, the Obama administration hailed the IPAB, which was set up as a non-partisan board able to formulate Medicare policy while insulated from political pressures, as a crucial component of health care cost containment. However, given that Medicare spending growth has increased at a rate far below the target set by the ACA, the IPAB will not be required to propose reductions in Medicare reimbursement and, therefore, its most controversial aspect may not become relevant. In addition, three years after enactment of the ACA, the 15-member IPAB has no members, with no indication of forthcoming nominations.

"Regardless of the IPAB's future, one thing is clear: rather than removing politics from Medicare, the board's difficult early journey has underscored just how entrenched politics are in health care policy," the authors write.