The Senate on Tuesday in a unanimous vote passed a bill (S 870) that aims to improve care coordination, management, and outcomes for Medicare beneficiaries with chronic conditions.
Broadly, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act seeks to improve how Medicare pays for care and reduce costs in the long term.
The Senate Finance Committee's Chronic Care Working Group introduced the bill in April, after a similar measure failed to gain traction in the chamber last year.
The new bill would implement Medicare payment policies intended to encourage beneficiaries, including those enrolled in Medicare Advantage (MA) plans, who have chronic conditions or who have had strokes to receive care through accountable care organizations (ACOs) and telehealth services. For instance, the bill would allow MA plans and ACOs to expand coverage for and provide telehealth services for certain procedures, such as home dialysis and stroke assessments.
The measure also would:
- Extend by two years the demonstration period for CMS' Independence at Home program, which allows medical practices to deliver comprehensive primary care services at beneficiaries' homes;
- Increase the number of allowable Medicare beneficiaries in the program from 10,000 to 15,000 and
- Permanently extend the MA Special Needs program for beneficiaries who are chronically ill.
Further, the bill would allow Medicare reimbursements for additional non-health and social services, such as meal deliveries and transportation to doctors' appointments.
The Congressional Budget Office (CBO) earlier this year projected the bill would generate $80 million in savings, which would help to offset the measure's costs. Overall, CBO said existing Medicare funds would cover the bill's costs, meaning the measure would not increase federal spending.
The measure now heads to the House, where experts say the legislation is unlikely to pass, mHealthIntelligence reports. However, according to mobihealthnews, House lawmakers have proposed several provisions of the bill as independent measures, including:
- HR 3727, which would expand telemedicine under MA;
- HR 1148, which includes the CHRONIC Care Act's telestroke provisions; and
- HR 3178, which includes the CHRONIC Care Act's kidney dialysis provisions.
Senate Finance Committee Chair Orrin Hatch (R-Utah) in a statement said, "This legislation will improve disease management, lower Medicare costs and streamline care coordination services—all without adding to the deficit." He added, "Addressing these issues is critical for the increasing number of individuals who live with multiple chronic conditions and will age into the Medicare program over the next two decades."
Hatch continued, "The CHRONIC Care Act is one of the few bipartisan health care bills to pass the Senate this Congress, and I urge my colleagues in the House to act quickly on this legislation and get it to the president’s desk to be signed into law."
Senate Finance Committee Ranking Member Ron Wyden (D-Ore.) on the day of the bill's passage said, "Today is a big day in the ongoing effort to update and strengthen Medicare's guarantee to seniors." He added that he, Hatch, and other members of Congress will work together "to ensure these policies become law as soon as possible" (Sullivan, The Hill, 9/27; Comstock, mobihealthnews, 9/27; Wicklund, mHealthIntelligence, 9/27; Hatch statement, 9/27).
Learn how to implement Medicare's Chronic Care Management (CCM) codes
Medicare’s Chronic Care Management (CCM) codes can help medical groups finance the practice investments necessary to succeed in value-based care. However, providers have been slow to adopt CCM codes, with claims submitted for less than one percent of eligible beneficiaries in the program’s first year.
Read this report for guidance on overcoming these and other hurdles to capturing CCM revenue. Then, review the additional case studies to see how your peers have used CCM codes to support other strategic aims.