22 Jun Task Force Letter to Senate Finance Committee Chronic Care Working Group
The Task Force responded to the May 22nd stakeholder request of the bipartisan Senate Finance Committee’s chronic care working group. The recommendations address the work group’s three designated policy objectives: the proposed policies increase care coordination among individual providers across care setting who are treating patients living with chronic diseases; streamline Medicare’s current payment systems to incentivize the appropriate level of care for patients living with chronic diseases, and facilitates the delivery of high quality care, improve care transitions, produce stronger patient outcomes, increase program efficiency and contribute to overall effort that will reduce the growth in Medicare spending.
Task Force Response Summary
1. Improve Quality and Cost for Medicare Beneficiaries. The Task Force urges the Committee’s chronic care working group to consider the development of models in traditional Medicare that are led by Medicare Advantage plans, Accountable Care Organizations and other organizations participating in Medicare’s alternative payment models.
2. Expand Value Based Insurance Design (VBID). CMS should test a VBID model in the Medicare Advantage program for beneficiaries with specific chronic conditions. VBID should be implemented in conjunction with other initiatives, such as care management, provider engagement, medication adherence, and other programs that will promote patient engagement and wellness.
3. Modernize Hospice and Advanced Illness Care. Increased hospice election is commonly associated with higher quality care, member and family satisfaction and less unnecessary care. However, the requirement that a member give up the ability to obtain “curative” therapy is not helpful and prevents beneficiaries from obtaining the type of palliative care available from hospice and certain levels of curative care the patient may need even though they are near end of life. As documented in several peer reviewed publications, when paired with effective care management, quality of care and cost savings can be achieved without limiting access to curative care.
4. Reform the Medicare ACO Programs. The Task Force believes the ACO and similar programs are well-placed for this call to action, as participants are accountable for the cost and quality of care for beneficiaries aligned to their ACO, for all services covered under Medicare Parts A and B.
5. Improve Risk Adjustment. Robust risk adjustment that properly compensates for these outsized expected costs can work to mitigate these incentives greatly.
Letter submitted on June 22, 2015