CHRONIC expanding Medicare and Telehealth
Congress is taking a small, but important, step towards expanding Medicare to include some long-term supports and services. A bipartisan (yes, bipartisan) measure before the Senate Finance Committee would give some Medicare providers additional flexibility in the way they care for people with chronic conditions, who are among the program’s highest need and highest cost beneficiaries.
The bill, called the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, nibbles around the edges of this important issue. Make no mistake, it would not expand traditional Medicare to provide anything like a long-term care benefit. Far from it. But it would begin to break down what has until now been a largely impenetrable wall between Medicare and those supports and services.
Given the current political environment, Congress would take a major step by even acknowledging that people with chronic conditions may require services that Medicare does not now offer. The sponsors of the bill include Finance Committee Chair Orrin Hatch (R-UT) and top committee Democrat Ron Wyden (D-OR) as well as Johnny Isakson (R-GA) and John Warner (D-VA). The Finance panel held a hearing this on the bill yesterday and plans to vote next week to send the measure to the full Senate.
Expanding Managed Care
CHRONIC would expand the use of telehealth, extend and expand a home-based medical practice experiment called Independence at Home, and improve the Medicare appeals process for people in risk-based insurance plans such as Special Needs Plans (SNPs). But the biggest changes would apply to the care provided by managed care programs.
One would expand the use of those special needs plans, which are explicitly aimed at people with chronic conditions and high medical needs. Some of these programs already provide supports and services as part of their benefit packages but they remain relatively small.
The other would give Medicare Advantage plans important new flexibility to offer social supports and other non-medical services to their members. About one-third of Medicare enrollees are in MA plans.