Sen. Wyden Introduces Better Care, Lower Cost Act
Wednesday, January 22, 2014
by: VNAA Policy Team

Section: Public Policy and Advocacy

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On Jan. 5, Sens. Wyden (D-OR) and Isakson (R-GA) introduced legislation entitled the Better Care, Lower Cost Act, also known as S. 1932. The bill addresses concerns that Medicare is not doing enough to take care of chronically ill patients, and the limitations of the fee-for-service system prevent a coordinated focus on these patients and their needs. This is critically important because most Medicare enrollees suffer from multiple chronic conditions.

According to CMS, in 2010, 68 percent of Medicare enrollees suffered from two or more chronic conditions, and accounted for 93 percent of Medicare spending (roughly $487 billion annually). Additionally, 98 percent of hospital readmissions involved beneficiaries with multiple chronic conditions. There are existing models of care that are meeting the needs of some chronically ill patients, at lower costs, but the vast majority of these innovative care delivery models are located in the Pacific Northwest, the Midwest and Northeast, leaving millions of Medicare enrollees across the country without access to proven, integrated models of care.

The Better Care, Lower Cost Act removes the barriers that prevent Medicare providers from building on existing successful delivery models and provides a framework for encouraging innovative chronic care delivery across the country. Specifically, the bill supports providers and plans wanting to actively engage and care for this population. This proposal does not include any form of the attribution rule, encourages specialized team-based care with rewards for improving patient’s outcomes, uses telemedicine and knowledge networks to increase access in rural areas and includes vital case management services proven to increase medical compliance. The bill focuses on the unique needs of Medicare enrollees.

To help transition Medicare from a program that simply treats sickness to one that promotes wellness, this proposal identifies the patients most in need and provides them with better care before becoming the most acutely and persistently ill. The bill also aims to improve standards of care for Medicare enrollees. Lastly, the bill provides for changes to medical school curricula in order to better respond to the evolving needs of the chronically ill.
VNAA will be meeting and working with Sens. Wyden and Isakson on this legislation.
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