October 28, 2016
Contact: Nisha Bhat
National Coalition on Health Care (NCHC)
202-638-7151, ext. 106
Broad Stakeholder Coalition Presses Lawmakers to Move Forward with Chronic Care Bill
Statement by National Coalition on Health Care President and CEO
John Rother on the Senate Finance Committee Chronic Care Working Group Discussion Draft
“By bringing down barriers to better care for the chronically ill in both Original Medicare and Medicare Advantage, this draft bill promises to spur delivery and benefit innovation across the health care system. The National Coalition on Health Care calls on the Finance Committee, and then Congress as a whole, to move forward expeditiously with meaningful chronic care legislation.
“Better chronic care is fundamental to ensuring health care affordability in the United States. NCHC and its members have long advocated for a strong legislative response, beginning with chronic care in Medicare. We commend the leadership and dedication of the Finance Committee, Chairman Hatch, Ranking Member Wyden, Senator Warner and Senator Isakson, and their staffs.
“Of course, the details of all these policies will be crucial; NCHC and its members will continue to work with Congress to ensure the strongest possible bill. But Senators Hatch, Wyden, Isakson, and Warner have given their fellow lawmakers a remarkable opportunity: to demonstrate that bipartisan commitment can produce constructive solutions to health care affordability challenges. Congress should take that opportunity…and with the cost of care steadily climbing, they should take it soon.”
Highlights of the draft legislation are listed below:
Medicare Advantage (MA) health plans will be empowered to deliver care through telehealth technology, deploy non-medical services that help maintain or improve a patient’s health, and lower cost-sharing for patients with chronic illness. MA Special Needs Plans (SNPs), a source of significant innovation in care delivery, will have both new standards to meet and the assurance that the SNP program is permanently authorized. Together with improvements to Medicare’s risk adjustment model included in the draft bill, MA plans would have new tools and resources to deliver great care to their chronically ill enrollees.
In Original Medicare, beneficiaries will get the chance to choose an Accountable Care Organization by designating an ACO clinician as their primary care provider—in addition to existing attribution mechanisms. ACOs will have the option of prospective assignment, so they can better coordinate care for their patient population. Additionally, ACOs in risk-based payment models will be permitted to offset some beneficiary cost sharing for primary care and will be allowed to deliver services in patients’ homes using telehealth technology. These reforms should help Medicare ACOs better realize their potential to transform payment and delivery in Original Medicare.
Finally, the discussion draft contains important improvements to the Medicare benefit, broadening coverage of stroke telehealth services and permitting monthly End-Stage Renal Disease check-ups to be delivered via telehealth technology in the patient’s home. It also makes adjustments to the Independence at Home Practice Demonstration that could strengthen the case for making that home-based primary care model a permanent part of Medicare for the frailest Medicare beneficiaries.
The National Coalition on Health Care (NCHC), the oldest and most diverse group working to achieve comprehensive health system reform, is a 501(c)(3) organization representing more than 80 participating organizations, including medical societies, businesses, unions, health care providers, faith-based associations, pension and health funds, insurers and groups representing consumers, patients, women, minorities and persons with disabilities. Member organizations collectively represent – as employees, members, or congregants – over 100 million Americans.
Some members of NCHC do not, or cannot, take positions either on specific legislation, strategies or on any policies outside their respective mission areas. However, all that can, do endorse broad policy positions in support of comprehensive health system change.