Restructure Medicare & Medicaid: Medium-Term Policy Options From the Report of the National Commission on Fiscal Responsibility and Reform : : : Deficit Reduction Medium-Term Policy Options F2012-F2020E" Convert the federal share of Medicaid payments for long-term care into a $89 billion capped allotment Reform Tricare for Life? to increase cost sharing for Military retirees $55 Cut federal spending on graduate and indirect medical education $54 Reduce taxes that States may levy on Medicaid providers $49 Expand ACOs, payment bundling, and other payment reform $38 Accelerate phase-in of DSH payment cuts*, Medicare Advantage cuts $37 and home health cuts in PPACA Other* $73 Total Deficit Reduction F2012-F2020E $395 billion “~~ Note: 7) Cost reductions are Fiscal Commission staff estimates based on CBO and other available sources. Most numbers were generated pre-healthcare reform and may differ significantly. 2) Tricare for Life is a supplementary military health insurance designed to minimize Medicare-eligible military retirees” out-of-pocket medical expenses. 3) DSH is the Medicare and Medicaid disproportionate share hospital payments for hospitals that receive disproportionately large Medicare and Medicaid patients. 4) Other includes reduce Medicaid administrative costs, increase nominal Medicaid copays, cut Medicare payments for bad debt, increase cost Sharing for federal civilian retirees and place dual-eligible individuals in Medicaid Managed Care. Source: National Commission on Fiscal Responsibility and Reform, “The Moment of Truth: Report of the National Commission on Fiscal Responsibility and Reform,” 12/1/10. (@)) www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 327 Restructure Medicare & Medicaid: Long-Term Policy Options From the Report of the National Commission on Fiscal Responsibility and Reform e Set global target for total federal health expenditures after 2020 (Medicare, Medicaid, CHIP, exchange subsidies, employer health exclusion),