Medicare Advantage and the Chronic Care Act of 2017 Improve Care for Chronic Conditions

Allyson Schwartz

In April, S.870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 was introduced in the U.S. Senate. On Tuesday May 16, Senate Finance Committee Chairman Hatch and Ranking Member Wyden will convene a hearing to examine the bill and discuss ways to improve health outcomes for patients living with chronic illnesses. This legislation is the result of years of work by the U.S. Senate Chronic Care Working Group, during which they sought feedback from clinicians, plans, advocates, and community partners on actions that could be taken to better address the needs of individuals with chronic conditions. Better Medicare Alliance participated in this process and wrote a letter that can be viewed here. We are pleased and supportive of the bipartisan legislation that is the result of this effort.

More and more Americans, particularly those over 65 years old who rely on Medicare, are living with serious chronic conditions like diabetes, cardiac disease, hypertension, COPD, dementia, and multiple other conditions. In fact, approximately 92% of older adults have at least one chronic condition, 77% have at least two, and 14% have six or more. This cohort of Medicare beneficiaries with six or more chronic conditions account for almost half of total Medicare spending. They are high need, high risk beneficiaries. If we want to reduce Medicare spending, especially for these very complex patients, we need to be smarter about the way we finance and deliver care.

We understand this at Better Medicare Alliance and advocate for the value of early intervention, care management, and patient engagement that improves outcomes for individuals in Medicare Advantage living with chronic conditions. While much is already being done to improve care for these patients, we know more can be done to encourage innovative care delivery that addresses the social determinants of health and connects beneficiaries to the care they need. This includes greater flexibility in benefit design to offer community based care, as well as innovative interventions like telemedicine. As the evidence shows, these advances would improve the ability of plans and providers to offer more targeted care and achieve better outcomes for patients with critical needs.

That is why Better Medicare Alliance supports the CHRONIC Care Act of 2017.

Here are some key provisions in the Act that would enhance the ability of Medicare Advantage to improve care for beneficiaries with chronic conditions. We hope to see these provisions become law in the near future:

1. Permanently authorize Medicare Advantage Special Needs Plans (SNPs).
2. Provide more flexibility in allowable Supplemental Benefits in Medicare Advantage, such as healthy meals and transportation to medical appointments.
3. Expand the Center for Medicare and Medicaid Innovation (CMMI) Medicare Advantage Value-Based Insurance Design (VBID) Model to all 50 states.
4. Expand telemedicine benefits in Medicare Advantage.

Medicare Advantage is leading the way in care coordination, reducing costs for those with chronic conditions, and empowering patients to take responsibility to improve their health. The changes proposed in this legislation will enhance the delivery of high quality care, increase efficiency, improve care transitions, achieve better patient outcomes, and contain costs in Medicare spending. We look forward to working to see this important legislation become law.