New Legislation Seeks to Improve Long-Term Care for Medicare Beneficiaries
January 16, 2014 02:54 PM
The Bipartisan Better Care, Lower Cost Act seeks to improve care coordination for beneficiaries with multiple chronic conditions, the most-expensive and fastest-growing portion of the Medicare population.
Senators Ron Wyden (D-OR) and Johnny Isakson (R-GA) and Representatives Erik Paulsen (R-MN) and Peter Welch (D-VT) earlier this week introduced the Better Care, Lower Cost Act. The new bill aims to improve care coordination for Medicare beneficiaries with multiple chronic conditions. The legislation would expand the use of multidisciplinary health teams to keep patients as healthy as possible in their homes and communities.
According to Centers for Medicare and Medicaid Services, 68 percent of Medicare enrollees have multiple chronic conditions, and account for 93 percent of Medicare spending. Additionally, 98 percent of costly hospital readmissions involved beneficiaries with multiple chronic conditions.
“Medicare reform must be built around offering better quality, more affordable care for these seniors,” said Senator Wyden. “Fortunately, there are pioneering practices and plans that are paving the way. The point of our bipartisan legislation is to break government’s shackles on innovation so that these providers are the norm rather than the exception.”
Said Senator Isakson, “I’m proud to join Senator Wyden in introducing this legislation, which addresses our health care system’s challenge of managing chronic medical conditions by allowing patients to voluntarily enroll in a program that incentivizes health care providers to invest in prevention and keeping patients healthy. I encourage my Senate colleagues to support this legislation because it is critical to the future of Medicare and our health care system.”
The legislation creates the “Better Care Program,” allowing health plans and groups of providers to form “Better Care Plans” or “Better Care Practices,” (BCPs) respectively. This program would be voluntary and open to Medicare enrollees suffering with chronic illnesses. Participating plans and practices would receive newly calculated risk-adjusted, capitated payments rewarding better health outcomes for enrolled beneficiaries.
BCPs would be allowed to focus and specialize in chronic care delivery and management. Under current law, the so-called “attribution rule” strictly limits the ability of provider-led organizations to reach out to sicker patients and provide them with the highest-quality, integrated chronic care services.
NAHC staff is currently reviewing the details of the legislation. Any developments on this bill and NAHC analysis will be provided in future issues of NAHC Report.
For more information on the Better Care, Lower Cost Act, please click here.