Better Medicare For Those With Chronic Disease – Forbes

U.S. Sens. Mazie Hirono (D-HI), Patty Murray (D-WA) and Chris Van Hollen (D-MD) hold a news conference following the release of the GOP plan to replace Obamacare at the U.S. Capitol June 22, 2017 in Washington, DC. The Democrats were critical of Senate Republicans’ plan to overhaul the Affordable Care Act and and it’s effect on people living with chronic diseases. (Photo by Chip Somodevilla/Getty Images)

The Senate has quietly and unanimously passed a bill that would improve some Medicare benefits for people with chronic disease. The measure would do many good things but the most important is this: It would take important steps toward breaking down the wall between medical treatment and non-medical supports and services in Medicare, beginning a process that would make it much easier for frail seniors to receive the right care when they need it.

The bipartisan measure, called the called the Creating High-Quality Results and Outcomes Necessary to Improve Chronic  Care (CHRONIC) Act of 2017, was sponsored by Senate Finance Committee Chair Orrin Hatch (R-UT) and top committee Democrat Ron Wyden (D-OR) as well as panel members  Johnny Isakson (R-GA) and John Warner (D-VA). It would give Medicare managed care plans new flexibility to  better organize care and provide non-medical supports and services. It would also expand a temporary program aimed at providing team-based care at home for people with complex medical conditions, and increase the use of telehealth services.

Medicare does not pay

Today, with a few narrow exceptions, Medicare does not pay for long-term supports and services such as home health aides, home modifications, rides to the doctor and the like. It provides limited home health services only after someone has been hospitalized for three days, and only a short period of time.

While many consumers believe Medicare does provide these long-term benefits, it generally does not. As a result, a frail senior or a younger person with disabilities must navigate multiple systems and payers to assemble the care they need. It is a nightmare. Millions of people fall through the cracks. Some die as a result.

Medicaid does pay for some of these services, but only if you are very frail and impoverished. A middle-income person who has say, diabetes and congestive heart failure, is on her own.

The bill would open the door to important new Medicare supports and services, but only for those in managed care.

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