Better care for these high-need individuals is an indispensable element of any serious effort to slow the growth of health care spending while improving quality.
Expanding Care Coordination for High-Cost, High Need Beneficiaries
In both public programs and the private sector, 5% of patients account for 50% of health care costs. These patients typically face multiple chronic conditions and functional limitations that together lead to enormous health care costs, disability, and premature mortality. Better care and services for these often-vulnerable individuals is both a fundamental moral responsibility and an indispensable element of any serious effort to curb overall health care spending.
Improve Chronic Care in Medicare Advantage and Medicare Accountable Care Organizations (ACOs)
In Medicare, meeting that responsibility means doing more to help MA plans and ACOs to improve care and lower costs – particularly for the most vulnerable patients.
- Risk adjustment must fully account for the additional cost of caring for dually eligible, frail, or disabled beneficiaries.
- To encourage a more robust response to the social determinants of health, Congress should remove regulatory barriers that prevent accountable entities (health plans or ACOs) from investing program dollars on behavioral health, housing, and social and long-term services and supports.
Patient-Centered Care Planning
Any patient’s or consumer’s priorities should drive the care and services they receive. When chronic disease evolves into serious or advanced illness, it is particularly critical that a patient’s own preferences and choices guide the course of treatment. NCHC supports the following improvements to the current benefits in Medicare and across our health care system:
- Ensure that palliative care options are available and made known to patients throughout the course of illness
- Improve care for patients with advanced illness by reimbursing for care planning and providing relief from cost-sharing for those services
Statement by John Rother, President & CEO of National Coalition on Health Care “People with multiple chronic conditions account for the majority of health spending, and their care is too fragmented and costly. This legislation is a promising beginning of the effort to address the problem, but certainly not the end. “NCHC applauds the Committee, its Members, […]
NCHC expresses support for key provisions of S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, and suggests steps to further strengthen the legislation as it moves forward