The new law allows Medicare Advantage plans to target important non-medical health-related services such as meals, transportation, and home modifications to patients with multiple chronic conditions. It also includes language to better align and integrate care for those who are eligible for both Medicare and Medicaid.
Medicare beneficiaries with four or more chronic conditions account for 90 percent of Medicare hospital readmissions and 74 percent of overall Medicare spending. Research shows that providing social services not traditionally covered by Medicare can reduce unnecessary hospitalizations and reduce emergency visits for some people living with multiple chronic conditions.
“A major driver of the country’s fiscal outlook lies with the continued growth in Medicare and Medicaid spending,” said BPC Senior Vice President Bill Hoagland. “These chronic care provisions mark an important first step to improving care for this vulnerable population and the fiscal health of our nation.”
Today, three in four Americans over age 65 have multiple chronic conditions and the cost of providing their care is rapidly increasing. Challenges for high-need adults can be even greater for those who are low-income or disabled and eligible for both Medicare and Medicaid. With the number of older Americans expected to double by 2050, a significant strain will be put not only on the nation’s health care system but on families.
“This could be a real opportunity to shift toward more patient- and family-centered care,” said BPC Director of Health Policy Katherine Hayes. “Decisions made by the Secretary of Health and Human Services could start a transformation from care based on what is covered to care based on what patients and their families need to remain at home.”
Many of the chronic care provisions are expected to be issued in the Medicare Advantage rule in December.