Washington, D.C.– Today the Bipartisan Policy Center released the first of two reports that call for new policy proposals that could help patients living with a serious illness and their families. These are patients with multiple chronic conditions, like heart disease and diabetes, but also includes those living with life-threatening diseases such as Alzheimer’s and certain cancers. While health insurance will cover their medical care—hospital and doctor visits—there are other critical health-related services they need, such as home-delivered meals, minor home modifications, more care management than is typically required, and telehealth services in-home. These services have proven effective in improving quality of care and lowering costs, but generally aren’t covered by Medicare.
BPC believes that policy changes in four key areas, including Medicare, telehealth, workforce, and family caregiving, could help improve the care-management for these patients in the short-term. This first report focuses on changes to Medicare payment and delivery models as well as improving access to patient care through telehealth.
“Americans with serious illness, their families and caregivers face significant challenges navigating our nation’s health care system,” said Katherine Hayes, BPC’s director of health policy. “Improving patient-and-family centered care for Medicare beneficiaries and expanding their access to telehealth services will allow patients to remain more independent and live in their own homes. Too often services are based on what is reimbursed under Medicare, rather than what patients want and need.”
The report points out that while Congress and the administration have taken steps to provide flexibility for covering non-medical health-related benefits that better reflect patient and family needs, a more comprehensive approach to the financing and delivery of long-term care services in Medicare Advantage plans and Medicare fee-for-service is critical to improving quality of care, value, and the needs of the patient.
BPC’s recommendations are backed by a recent study by Discern Health that identified four characteristics of a payment and delivery system that results in the highest-quality of care for those with serious illness including: 1) care coordination services; 2) individual care plans based on patient and caregiver needs; 3) interdisciplinary care teams that communicate regularly and monitor a patient’s health and 4) access to in-home services, including telehealth services.
“While telehealth is not a silver bullet to improving care for these with serious illness, it has the potential to improve access to providers in medically underserved urban and rural areas,” added Hayes. “Telehealth services can also allow patients who have significant mobility issues to receive much needed services in their own homes, where they are more comfortable.”
BPC will release a second report in November that will offer recommendations to improve support to family caregivers and to create a more sustainable and viable direct-care workforce.