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Aim of New Bill Is Lowering Health Care Costs
By
Stephen Baetge
Staff Writer
The
newly-introduced Reaching Elders with Assessment and Chronic
Care Management and Coordination (RE-Aligning Care) Act — considered
by some to be an essential health care reform that protects
the future of American seniors — was introduced last month
with praise from the nation’s elder care experts.
The new legislation on Capitol Hill proposes implementing recommendations from
the Medicare Payment Advisory Commission (MedPAC) and the Institute of Medicine
to fill a significant gap in traditional Medicare.
If passed, the law will cover comprehensive geriatric assessment and care coordination
services for Medicare beneficiaries suffering from chronic conditions.
The bill was jointly introduced in Congress by Senators Blanche Lincoln, D-Ariz.,
Susan Collins, R-Maine, and Rep. Gene Green, D-Texas, as S. 1004 and H.R. 2307.
“This bill realigns Medicare to provide high-quality, cost-effective care
to older adults with multiple chronic illnesses,” stated Sen. Lincoln. “It
is an important step forward in recognizing and remedying the impact that multiple
chronic conditions have on individuals, their caregivers and the Medicare program.”
Approximately 20 percent of Medicare beneficiaries who have five or more chronic
conditions, such as heart disease and diabetes, now account for roughly 75 percent
of Medicare spending.
On average, these patients see 14 different physicians annually. Even if their
individual health care providers deliver care efficiently, their overall care
may be fragmented and inefficient unless these providers coordinate the care
they receive and help them to manage their health problems between visits, according
to MedPAC reports.
Recent studies have shown that the patient-centered chronic care coordination
models the RE-Aligning Care Act would support both improve the health of high
cost beneficiaries with multiple chronic conditions and reduce or control costs.
If it becomes law, the RE-Aligning Care Act would authorize traditional Medicare
to pay physicians and other eligible health care providers to provide eligible
beneficiaries with comprehensive geriatric assessments and chronic care management
along with coordination from provider to provider and setting to setting.
Medicare beneficiaries who have two or more chronic conditions, which the U.S.
Health and Human Services Secretary identifies as “likely to result in
high expenditures,” would be eligible for the services.
Beneficiaries with dementia and one or more other chronic illnesses would also
be eligible.
A geriatric assessment is a comprehensive review of an individual’s physical
and mental condition, which serves as the basis for a comprehensive care plan
for the individual, including evaluations of cognitive and functional capacities,
medication regimen and adherence, social and environmental needs, and caregiver
needs and resources.
Chronic care management and coordination services include development and implementation
of a care plan that coordinates services provided by all health care providers
and agencies involved in the individual’s care.
Medication monitoring and management, education and counseling services for the
individual — including self-management services when appropriate — and
management of transitions among health care professionals and settings of care
are also covered under the auspices of chronic care management.
The proposed legislation has been lauded by senior health experts including the
American Geriatrics Society (AGS) and the Alzheimer’s Association.
Supporters view the congressional action as providing both necessary health care
to meet the needs of America’s burgeoning senior population and a vital
cost-cutting measure amidst concerns about Medicare’s fiscal stability.
“The RE-Aligning Care Act is an absolutely essential piece of health care
reform legislation that will fill a significant gap in Medicare, improve care
for the most vulnerable and costly Medicare patients, and help rein in Medicare
spending,” stated AGS President Cheryl Phillips, M.D.
“Medicare beneficiaries who see multiple health care providers in differing
settings may not get the care they need — unless there is care coordination
across settings, among providers and between office visits,” she added.
“Most Americans with Alzheimer’s disease also suffer from multiple
chronic health conditions, such as heart disease and diabetes,” Robert
J. Egge, vice president of public policy and advocacy for the Alzheimer’s
Association, explained. “This significant legislation will improve the
coordination of care for the growing aging population, including those with Alzheimer’s
disease and other dementias.”
Future legislative action is pending in Congress.
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Metropolitan News Company, Inc.
