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Senate Bill Might Bolster Medicare Chronic Care Management

A proposed bill would improve chronic care management for Medicare beneficiaries and encourage participation in value-based care programs.

Chronic care management bill

Source: Thinkstock

By Jennifer Bresnick

- The Senate Committee on Finance will be taking a hearing today on a bill that aims to improve the delivery of chronic care management and provide more opportunities for Medicare patients to benefit from population health management activities.

The bipartisan legislation, “Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017,” was introduced by Senate Finance Committee leaders, including Chronic Care Working Group Chairman Orrin Hatch (R-UT) and Ranking Member Ron Wyden (D-OR).

“From the beginning, members of this committee have worked in a bipartisan fashion to address chronic illnesses and improve outcomes for beneficiaries,” Hatch and Wyden said. 

“The CHRONIC Care Act is the culmination of these efforts and with a focus on bipartisan solutions, would streamline care coordination and strengthen treatments for our seniors.”

The bill contains a number of proposals including expanding access to home dialysis treatment, coordinating care for patients with complex needs, improving medication synchronization, allowing states to adapt benefits to the needs of costly beneficiaries, and encouraging the growth of accountable care organizations (ACOs) to improve population health management and the coordination of care.

Specific changes to the Medicare Shared Savings Program (MSSP) would allow participating ACOs to request to have their attributed patient populations assigned prospectively at the beginning of a performance year instead of at the end of the year. 

This may allow ACOs to better allocate services to chronic disease patients and develop a more robust understanding of the financial risks of their population.

MSSP ACOs would also be able to make incentive payments to patients who receive qualifying primary care services.  Through the ACO Beneficiary Incentive Program, providers who choose to participate would have funds to offer up to $20 per service, which may encourage more participation in preventive care. 

A number of chronic care management experts will testify on the potential impact of the bill.  Among those currently slated to appear are Senators Brian Schatz (D-HI) and Roger F. Wicker (R-MS) as well as Katherine Hayes, JD, Director of Health Policy at the Bipartisan Policy Center and Stephen Rosenthal, Senior VP of Population Health Management at Montefiore Health System.

The hearings come at an interesting time for the Committee, considering the current political climate surrounding the healthcare debate. 

After the American Health Care Act (AHCA) squeaked through the House of Representatives earlier this month, the nation is now awaiting the Senate’s take on potentially rolling back much of the Affordable Care Act.

In contrast to the AHCA’s intent to reduce the scope of services commercial health plans are required to deliver to their customers, including care for pre-existing chronic conditions, the CHRONIC Care Act would expand the number of supplementary benefits available under Medicare Advantage plans and shore up support for Medicare’s risk-based reimbursements and pay-for-performance programs.

A live stream of the event will be available at 10:00 Eastern time on Tuesday, May 16, 2017.

“This hearing will give members the opportunity to examine the CHRONIC Care Act and highlight policies that, if enacted, will help patients struggling with chronic illnesses,” Wyden and Hatch said.


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