Is there a senior in your family that is on Medicare AND has a chronic health condition?
A chronic illness such as heart disease, diabetes or even cancer?
That is no fun! We know how hard that can be!
Especially when the doctors don’t talk to each other.
And sometimes prescribe drugs that may work at cross purposes, or even contra-indicated.
According to an AP story, all of this takes a toll on the patient AND on the Medicare budget.
As such, a bipartisan group of lawmakers recently proposed a new approach aimed at
keeping patients healthier and avoiding hospitalizations.
Proposed Medicare Changes: New Bill to Overhaul Chronic Care of Patients
Apparently, they are calling it the Better Care Program. According to the proposed plan,
teams of doctors, nurses and social workers would get a flat fee for each Medicare patient.
The goal of the bill is to improve care coordination, which would benefit not only the patient,
but also move Medicare away from paying for tests and treatments individually.
The proposed legislation is being sponsored by Sen. Ron Wyden (D-Ore).
Senator Wyde is expected to take over leadership of the Finance Committee, which oversees Medicare.
Joining Sen. Wyden are Sen. Johnny Isakson (R-Ga.), and Reps. Erik Paulsen (R-Minn.), and Peter Welch (D-Vt).
According to the AP article, Sen. Wyden is calling it “chronic disease reform.”
“More than two-thirds of Medicare beneficiaries are dealing with two or more chronic conditions.”
And spending on chronic care patients accounts for more than 90% of Medicare’s budget.
President Barack Obama’s health care law created “accountable care organizations”
for Medicare, which aim to improve coordination. Lawmakers are currently overhauling
the way the program pays doctors, with the goal of rewarding high-quality care.
Many people, including “doctors and hospital administrators, believe that care coordination can save money and improve health.”
Part of the challenge is that providing better coordination itself costs money.
The services of nurses and social workers are needed to keep patients from falling through the cracks.
Another issue is that patients in fragile health can and do wind up in the hospital
despite the best efforts of care givers to keep them at home.
The new proposal would build on the accountable care framework in the health care law.
The new “better care” organizations would be paid a flat fee per patient.
They would have more leeway on how to spend that money than is currently allowed under Medicare rules,
for example, by charging lower copayments for certain kinds of high-value services.
They would also be able to specialize in dealing with particular conditions.
Each senior who signs up with one of the groups would receive an individual care plan
that would reflect their particular situation.
What say you? Would you support such legislation? Please share your thoughts in the comments section below or on our facebook page.
However, if you are in need of medical insurance, with or without Medicare Advantage, please complete the form below and one of our experts will be in touch right away!