Circles of influence

While the healthcare system remains the most regulated industry in the nation, three new entities are emerging to further influence its forward progress. The boards-the Medicare Independent Payment Advisory Board (IPAB); the Center for Medicare and Medicaid Innovation (CMI); and the Patient Centered Outcomes Research Institute (PCORI)-are examining payment mechanisms, cost containment and quality of care.

Observers view IPAB as the first real attempt to control Medicare costs, and it's been met with aggressive opposition. The goal is for the board to enact cost-cutting policies, which the private market might also adopt, resulting in spending reduction systemwide.

"IPAB will assist plans in controlling health costs by creating a framework for provider payments closely aligned with overall medical costs," says Paul Keckley, executive director, Deloitte Center for Health Solutions. "Payments to physicians, long-term care providers and allied health professionals will follow guidance from IPAB."

PCORI is a private board with public collaboration, likely including support from the National Institutes of Health and the Agency for Healthcare Research and Quality.

Each of the three emerging groups will present information publicly and maintain transparent processes. How their influence will shape the future of healthcare is anyone's guess.

-Julie Miller