Bill Aims to Sharpen Medicare’s Focus on Chronically Ill

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

A better care plan nurse and her patientWe’ll be keeping a close eye on a bill proposed in January by a bi-partisan group of lawmakers led by Senator Ron Wyden (D-OR). The Better Care, Lower Cost Act of 2014 aims to improve medical care for people with chronic disease.

According to the authors, the legislation would remove barriers preventing Medicare providers from focusing on the chronically ill and help ensure that seniors have access to patient-centered chronic care regardless of where they live.

Participating providers would be called Better Care Plans (BCPs) and would be paid a fixed fee per enrollee. They would have to meet quality standards and provide all Medicare benefits. BCPs would be similar to ACOs in that they’re rewarded for keeping people well, but BCPs would not be restricted from targeting and enrolling the sickest patients. Also unlike ACOs, BCPs would be required to have a medical plan tailored to each individual.

The Partnership for Quality Home Healthcare expressed support for the proposal, saying it would strengthen chronic care delivery for the nation’s sickest seniors. Although the bill does not specifically include home care as part of the required package BCPs would offer, The Partnership points out that home health professionals have served as leading providers of disease management and prevention since the inception of Medicare and are Medicare’s lowest-cost source of such services.

“Skilled home health services are an essential tool in managing complex conditions,” The Partnership said in a press release following the bill’s introduction. “The Medicare home health benefit is widely recognized as clinically advanced, cost effective and patient preferred.”

The bill was assigned to a congressional committee on January 15 for consideration. GovTrack gives it only an 8% chance of getting out of committee. However, it’s worth noting that Senator Wyden recently succeeded Senator Baucus as chairman of the Senate Finance Committee, which oversees Medicare.

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