Senate Committee Advances Chronic Care Bill

MedPage Today, May 19, 2017

The bill targets services for chronically ill Medicare beneficiaries.

This article first appeared May 11, 2017 on Medpage Today.

by Joyce Frieden

The Senate Finance Committee unanimously approved a bill Thursday aimed at improving care for Medicare beneficiaries with chronic conditions.

The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 would increase access to telehealth for Medicare beneficiaries with chronic illnesses -- including those in Medicare Advantage plans -- as well as provide more incentives for enrollees to receive care through accountable care organizations (ACOs). It also would extend the Independence at Home demonstration program to keep people in their homes rather than hospitals, allow reimbursement for more non-health and social services, and extend permanently MA Special Needs plans that target chronically ill beneficiaries.

"One thing we hear a lot from ACOs is they have trouble keeping beneficiaries in-house rather than going to a provider outside the ACO, and that makes it harder to coordinate their care," a committee aide said. "This bill says that if you go to a primary care doctor in the ACO, we'll reduce or eliminate your cost-sharing for that primary care service. That will make beneficiaries stick to the ACO, and bring down their costs."

Sen. Ron Wyden (D-Ore.), the committee's ranking member, told MedPage Today that the measure is "transformative." "This is a formal recognition that this package of services -- the focus on care at home, the focus on new technology, the expanded role for primary care and prevention, which inevitably leads to more non-physician providers -- is the beginning of our push to update the Medicare guarantee. That's why it's transformative."

"Medicare is a promise, a guarantee that you get these defined benefits -- but Medicare 2017 does not resemble Medicare 1965," when the program first began, he continued. Back then, "All we were doing is talking about Medicare Part A and Part B ... Now we've got Medicare Advantage, coordinated care, patient-centered programs, and fee-for-service. This bill will benefit seniors in each one of the major ways in which they get their Medicare."

As for having the bill move through the House, Wyden said he has been talking about the bill to House Speaker Paul Ryan (R-Wisc.) and House Ways & Means Committee Chairman Kevin Brady (R-Texas). "Obviously the fact we passed this 26-0 will send a powerful message. This is an extraordinary development."

Finance Committee chairman Orrin Hatch (R-Utah) praised the bipartisan teamwork involved in getting the bill through the committee. "Given the contentious nature of our nation's current healthcare debate, it's remarkable we're able to get to this point," he said. "This endeavor has been the very definition of a team effort."

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