Senate Chronic Care Working Group Releases Long-Awaited Draft Proposal
Monday, October 31, 2016
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Section: Public Policy and Advocacy




The Senate Finance Committee’s bipartisan Chronic Care Working Group unveiled its latest draft proposal (draft bill | summary) to improve care for Americans living with chronic conditions – the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2016 – at a stakeholder meeting Thursday, October 27.

VNAA applauds the Working Group’s commitment to this important topic and its decision to extend the Independence at Home (IAH) demonstration, which VNAA called for in its June 2015 letter to the Working Group. As set forth in the discussion draft, the IAH demonstration would be extended by two year- through September 30, 2019, increase the cap on the total number of participating beneficiaries from 10,000 to 12,000, and allow practices up to three years to receive a shared savings payment before they are terminated from the demonstration. Currently, practices must be terminated if they do not receive such an incentive payment for two consecutive years.

VNAA also supports the decision to allow Accountable Care Organizations (ACOs) to include the home as an originating site for telehealth services. However, VNAA encourages the Committee to consider allowing Medicare to recognize non-ACO home health agencies as eligible for the telehealth reimbursement.

Absent from the Working Group’s latest proposal is the requirement that all Medicare Advantage plans offer the hospice benefit. VNAA and its members have been following this proposal closely since its inclusion in the December Policy Options document.

The Working Group’s proposal, which features many of the policies set forth in its December 2015 Policy Options document, is broken down by the following sections.
  • Receiving High Quality Care at Home
    • Extending the Independence at Home Model of Care
    • Expanding Access to Home Dialysis Therapy
  • Advancing Team Based Care
    • Allowing End-Stage Renal Disease Beneficiaries to Choose a Medicare Advantage Plan
    • Providing Continued Access to Medicare Advantage Special Needs Plans for Vulnerable Populations
  • Expanding Innovation and Technology
    • Adapting Benefits to Meet the Needs of Chronically Ill Medicare Advantage Enrollees
    • Expanding Supplemental Benefits to Meet the Needs of Chronically Ill Medicare Advantage Enrollees
    • Increasing Convenience for Medicare Advantage Enrollees Through Telehealth
    • Providing Accountable Care Organizations the Ability to Expand use of Telehealth
    • Expanding Use of Telehealth for Individuals with Stroke
  • Identifying the Chronically Ill Population
    • Ensuring Accurate Payment for Chronically Ill Individuals
    • Providing Flexibility for Beneficiaries to Be Part of an Accountable Care Organization
  • Empowering Individuals and Caregivers in Care Delivery
    • Eliminating Barriers to Care Coordination under Accountable Care Organizations
    • GAO Study and Report on Longitudinal Comprehensive Care Planning Services
  • Other Policies to Improve Care for the Chronically Ill
    • GAO Study and Report on Improving Medication Synchronization
    • GAO Study and Report on Impact of Obesity Drugs on Patient Health and Spending
A final version of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2016 is expected to be introduced in November.  VNAA will continue to monitor this topic and provide updates as they are made available. Please contact VNAA’s Director of Legislative Affairs, Nathan Constable, with any questions.
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