Why Every Generation Needs to Care About Medicare | Healthiest Communities

Why should younger Americans care about Medicare?

Over 175 million Americans – more than 50% of the population – are part of the millennial generation or younger. As these younger Americans brace for depleted Social Security benefits by the time they reach retirement age, the COVID-19 pandemic has made evident that concerns about health care access and costs do not begin once someone’s nearly 70. Access to high-quality health care is an essential aspect of a lifelong pursuit of wellness for all Americans.

Millennials, as well as Gen Xers and Gen Zers, need to care about Medicare because health care decisions made by CMS – including those that affect prescription drug coverage, physician pricing and surgery choices – can impact everyone.

Medicare initiatives often have spillover effects on private health care, as pointed to in a 2020 study examining the effect of warnings from CMS to primary care providers about heavily prescribing antipsychotic medication. Prescribing subsequently decreased for both Medicare and privately insured patients.

Health care decisions made by hospitals also can revolve around CMS policy.

Hospitals can make specific efforts to decrease noise, for example, due to CMS policy. Noise pollution – perhaps a seemingly minor issue – is an important concern for hospitalized patients and may impact their recovery.

Participation in the survey controls how much hospitals are reimbursed for care they provide to Medicare patients. If a hospital does not do the survey, they do not get reimbursed as much. Similarly, if they score poorly on the survey, it can affect their reimbursement. Hospitals have implemented numerous changes – such as using discharge nurses and having nurses conduct follow-up phone calls – specifically in an effort to increase their survey scores.

What all this means: Though the control CMS has is solely over reimbursement for Medicare patients, it affects everyone in a given hospital.

It may not be immediately clear what voice younger Americans can have in CMS policy. But regulations the agency issues are first proposed in a federal rule that is made publicly available. Anyone can comment on this rule. The comments are reviewed by CMS and often, responses to them are made publicly available.

As the former lead statistician on CMS contracts with the RAND Corporation, I responded to many comments from the public involving analytic decisions on nationwide CMS efforts. The good news is that CMS often changes a proposed rule to incorporate feedback from these comments. Individuals have enormous potential influence on CMS policy – and thus on our health care system as a whole.

There is a need for all individuals in this country to recognize the importance of CMS policy decisions and their effect on health care delivery, quality and cost. These decisions matter today for everyone – not just the Medicare crowd.