Senate Moves to Enhance Medicare Coverage for Chronic Conditions

To help improve the quality of care for the increasing number of Medicare beneficiaries with chronic conditions, the Senate this week unanimously passed a bill that promotes a team-based approach to care, expands the use of telehealth, and allows Medicare Advantage plans to cover such supplemental benefits as acupuncture and other alternative therapies.

The CHRONIC (Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care) Care Act was the result of a Senate working group that explored ways to better treat Medicare recipients with chronic conditions at a lower cost. More than two-thirds of current Medicare beneficiaries have multiple chronic conditions, such as heart disease, cancer, diabetes and stroke.

The legislation includes an expansion of a pilot program created by the Affordable Care Act that allows physician and nurse practitioner teams to coordinate care. Under that program, the teams make in-home visits and provide care based on plans tailored to an individual beneficiary’s chronic conditions.

For example, Medicare requires that a beneficiary receiving dialysis treatments in his or her home visit the doctor once a month. Under this legislation, some beneficiaries could get the physician assessment at home via telehealth technology.

The measure also would allow Medicare Advantage plans to offer a wider array of supplemental benefits to chronically ill beneficiaries beginning in 2020, such as acupuncture, counseling services and fitness benefits, none of which traditional Medicare covers. The bill also provides more use of telehealth under these plans.

AARP supports the CHRONIC Care Act. “It would take some important steps to improve care for the millions of Medicare beneficiaries with chronic conditions,” Joyce Rogers, AARP senior vice president for government affairs, said in a letter to senators.

“This legislation will improve disease management, lower Medicare costs, and streamline care coordination services — all without adding to the deficit,” Senate Finance Committee Chairman Orin Hatch, R-Utah, said in a statement. “This CHRONIC Care Act will mean more care at home and less in institutions,” said Sen. Ron Wyden, D-Ore., the ranking Democrat on the Finance Committee.

The nonpartisan Congressional Budget Office estimated that if this bill became law, it would reduce spending for Medicare and Medicaid by $217 million from 2018 to 2022.

The measure now moves to the House of Representatives, where several bills have already been introduced with similar changes to the Medicare program.