03 Aug The Task Force Joins Coalition Letter Supporting Representative DelBene’s Seniors’ Chronic Care Management Improvement Act of 2021
The Health Care Transformation Task Force joined coalition leaders to offer Representative DelBene (D-WA-1) support for the Seniors’ Chronic care Management Improvement Act of 2021, which would ensure that more chronically ill Medicare patients receive access to high-quality care. By removing the patient cost-sharing obligations from the Chronic Care Management (CCM) code, potentially millions of chronically ill Medicare beneficiaries will benefit from the care coordination and care management services the code supports.
Because CCM is a critical part of coordinated care, Medicare began reimbursing clinicians for primarily non-face-to-face chronic care management under a separate code in the 2015 Medicare Physician Fee Schedule rulemaking. We continue to support this initiative to effectively manage chronic conditions and improve the health of patients. Providers and care managers report many positive outcomes for beneficiaries who receive CCM services, including improved patient satisfaction and adherence to recommended therapies, improved clinician efficiency, and decreased hospitalizations and emergency department visits.
The creation of a separately billable code, however, imposed a beneficiary cost-sharing obligation for care management services. Under current policy, Medicare beneficiaries are subject to a 20% co-insurance requirement. This cost-sharing requirement can create a barrier to care, as beneficiaries are not accustomed to cost-sharing for care management services. Consequently, only 684,000 patients out of 35 million Medicare beneficiaries with two or more chronic conditions benefitted from CCM services over the first two years of the payment policy.
The HCTTF supports this legislation to waive the beneficiary coinsurance amount to more effectively manage chronic care conditions and improve the health of patients. Providers and care managers report several positive outcomes for beneficiaries who receive CCM services, including improved patient satisfaction and adherence to recommended therapies, improved clinician efficiency, and decreased hospitalizations and emergency department visits.