THE BUILDERS

Modern Healthcare - - 50 MEDICARE AND MEDICAID THE NEXT HALF-CENTURY -

JOSEPH CAL­I­FANO JR. helped launch Medi­care and Med­i­caid as Pres­i­dent John­son’s chief do­mes­tic pol­icy aide from 1965 to 1969. Later, as Health, Ed­u­ca­tion and Wel­fare sec­re­tary un­der PRES­I­DENT JIMMY CARTER, he con­sol­i­dated over­sight of the two pro­grams un­der the new Health Care Fi­nanc­ing Ad­min­is­tra­tion (which be­came the CMS in 2001).

ROBERT FET­TER and JOHN THOMP­SON of Yale Uni­ver­sity, start­ing in 1967, de­vel­oped the di­ag­no­sis-re­lated group sys­tem, clas­si­fy­ing med­i­cal con­di­tions and treat­ments into bun­dled cat­e­gories. It was used for the Medi­care prospec­tive pay­ment sys­tem im­ple­mented in 1983.

PRES­I­DENT RICHARD NIXON signed leg­is­la­tion in 1972 ex­tend­ing Medi­care to peo­ple re­ceiv­ing So­cial Se­cu­rity dis­abil­ity pay­ments and to peo­ple un­der age 65 with end-stage re­nal dis­ease.

PRES­I­DENT RON­ALD REA­GAN signed leg­is­la­tion set­ting per-diem lim­its on Medi­care hos­pi­tal pay­ments, paving the way for DRGs.

WIL­LIAM HSAIO of Har­vard Uni­ver­sity pub­lished stud­ies of re­source-based rel­a­tive val­ues for med­i­cal ser­vices that were used in de­vel­op­ing Medi­care’s re­formed physi­cian pay­ment sys­tem im­ple­mented in 1992.

CAROLYNE DAVIS, HCFA ad­min­is­tra­tor from 1981 to 1985, led the roll­out of the hos­pi­tal prospec­tive pay­ment sys­tem.

BRUCE VLADECK, HCFA ad­min­is­tra­tor from 1993 to 1997, over­saw the in­tro­duc­tion of Med­i­caid’s Sec­tion 1115 waiver pro­gram, ex­pan­sion of the prospec­tive pay­ment sys­tem, and early ex­per­i­men­ta­tion with Medi­care HMOs.

REP. HENRY WAX­MAN (D-Calif.) was a ma­jor ar­chi­tect of Med­i­caid ex­pan­sion from the mid-1980s through the pas­sage of the Af­ford­able Care Act in 2010.

PRES­I­DENT GE­ORGE W. BUSH cham­pi­oned and signed into law in 2003 the Medi­care Part D pre­scrip­tion drug ben­e­fit pro­gram.

TOM SCULLY, CMS ad­min­is­tra­tor un­der Pres­i­dent Bush, helped de­sign and im­ple­ment the Medi­care Part D pro­gram.

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