US Senate Takes up Chronic Care: An Opportunity for Positive Change

Last year, the US Senate Committee on Finance (SFC) took its first step toward developing legislation that would advance higher quality care at lower cost for the millions of Americans managing chronic illness.

Patients with multiple chronic conditions are the most difficult to treat, and also the most expensive to care for in the Medicare system. Medicare’s traditional fee-for-service payment system rewards providers for delivering increased volume of services but does not incentivize coordinated medical care, the type of care necessary for those with chronic conditions.

At a May 15, 2015, hearing, the Committee heard testimony from experts at the Centers for Medicare & Medicaid Services (CMS) and the Medicare Payment Advisory Commission (MedPAC). The hearing gave members an opportunity to more closely examine how current chronic care coordination programs work today, the challenges that remain, and possible solutions to improving health outcomes for Medicare beneficiaries. From that hearing, the SFC announced the formation of a bipartisan chronic care working group, co-chaired by Senators Johnny Isakson (R-GA) and Mark Warner (D-VA).

The working group was tasked with analyzing current law, discussing alternative policy options, and developing bipartisan legislative solutions for consideration by the full Finance Committee.

After meeting with interested stakeholders (including ASN) over the course of the year the working group in late December 2015 developed a white paper on ways to improve outcomes for vulnerable Medicare beneficiaries living with multiple chronic health conditions. The white paper is intended for possible use in developing future legislation.

With data-driven congressional and stakeholder input, the working group hopes to develop policy options that deliver high quality care, improve care transitions, produce stronger patient outcomes, increase program efficiency, and contribute to a reduction in the growth of Medicare spending. ASN is currently developing recommendations that will address these goals, such as expanding access to home dialysis, expanding telehealth options for ESRD patients, and allowing end stage renal disease beneficiaries to choose a Medicare Advantage (MA) plan if they wish.

For more information regarding ASN’s comments to the working group or other policy questions, please visit the ASN policy website.