While Medicare has in general been successful in ensuring that its beneficiaries have access to affordable health care, the sickest and poorest beneficiaries often face financial burdens that threaten this access. Rapid growth in Medicare spending, meanwhile, has pressured the government to cut payments to providers. This project will pursue two sets of strategies for improving Medicare's ability to serve all its beneficiaries, and to do so more efficiently. First, the researchers will examine policy options for helping low-income beneficiaries access a more unified and comprehensive set of Medicare benefits. Second, they will develop and model the impact of approaches for improving the way Medicare pays physicians—to protect access to care while setting payments that better reflect the value of services.