Expanding Care Coordination for High-Cost, High Need Beneficiaries

NCHC Writers
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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

Recent Publications from NCHC on this topic:

NCHC letter expressing support of & offering suggestions for key provisions of the CHRONIC Care Act

NCHC Supports Key Provisions of CHRONIC Care Act

Care Coordination for High-Cost, High-Need Beneficiaries

NCHC letter in support of Independence at Home model & HR 3623

National Coalition on Health Care Presses Congress for Bipartisan Solutions in Advance of Approaching Deadlines

After Debt Ceiling Deal, Congress Must Prevent Disruption to Nation’s Health System

NCHC Commends House Committees for Advancing Bipartisan Medicare Chronic Care Bills

Joint letter in support of H.R. 4006, the bipartisan Community-Based Independence for Seniors Act of 2017

NCHC letter in support of the Community Based Independence for Seniors Act (H.R. 4006)

Lack of Health Center, Medicare Extensions Will Harm Outcomes, Increase Costs

Joint letter applauding introduction of Chronic Disease Management Act of 2018

Recommendations for Senate Finance regarding substance use disorders

Joint letter applauding the Every Prescription Conveyed Securely Act

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