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Testimony by Katherine Hayes on Caring for Patients with Chronic Conditions to the Senate Finance Committee

“Since 2007, BPC’s Health Project has worked with stakeholders including patients, health care providers, plans, states, and federal policymakers to develop solutions that to promote better quality of care, while limiting the growth of health care costs in federal health programs. Under the leadership of the Health
Project’s Co-Chairs, former Senate Majority Leaders Bill Frist and Tom Daschle, BPC has released a series of reports and policy recommendations to address acute care and long-term care needs of frail and chronically ill individuals. On our efforts in long-term care delivery and financing, former White House and Congressional Budget Office Director Alice Rivlin and former Health and Human Services Secretary and Governor Tommy Thompson co-chaired the efforts.

“Research conducted by BPC and others makes clear that the presence of chronic conditions, particularly when paired with functional or cognitive impairment, is a key driver of utilization of medical services for Medicare beneficiaries. Medicare data from 2015 demonstrate that the number of chronic conditions that a patient has is directly correlative to higher Medicare spending and rates of hospitalization – as the number of chronic conditions rise, so do average Medicare costs per beneficiary. For instance, compared to beneficiaries with fewer than four chronic conditions, the Medicare beneficiaries who have four or more chronic conditions:

  • Incur average annual Medicare costs that are more than five times as high;
  • Have hospital readmission rates that are twice as high; and
  • Have four times as many emergency department visits.

“The presence of functional and cognitive limitations among chronically ill beneficiaries is also highly predictive of Medicare costs. Functional impairments are defined by difficulty in performing activities of daily living, such as bathing or transferring to and from bed without assistance. Cognitive impairments can include diminished intellectual capacity associated with dementia or Alzheimer’s disease, which can present safety concerns for patients. Medicare patients with functional or cognitive impairment have expenses that are more than three times as high as those without functional or cognitive impairment.”

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