On February 9th, 2018, the CHRONIC Care Act 2017 (Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care) was passed and signed into law by President Trump.
The new provisions will alleviate some of the burdens faced by older Americans with extensive medical issues and high-needs. The 19 million Medicare beneficiaries who have chosen a Medicare Advantage plan will see the most significant improvements, including the 2.3 million adults on a Special Needs Plan (SNP).
Changes to the CHRONIC Care Act
Among other changes, the new law:
- Expands the supplemental benefits offered under Medicare Advantage plans so that chronically ill enrollees can receive non-medical benefits that are expected to improve or maintain their health and overall function such as wheelchair ramps or bathroom handrails.
- Expands telehealth chronic care services for Medicare Advantage enrollees regardless of their geographic location. Previously, beneficiaries dealing with end-stage renal disease and acute stroke who did not meet limited requirements were required to make a high-risk visit to the doctor’s office each time he or she had a question.
- Allows Accountable Care Organizations (hospitals and healthcare providers who serve over 10 million Medicare beneficiaries) to provide incentive payments that encourage beneficiaries to receive primary care services (up to $20 per service).
- Promotes integrated care for people with Special Needs Plans who also receive Medicaid by establishing the Medicare-Medicaid Coordination Office and authorizing three defined Special Need Plans that correlate to claim processing and funding faster, as well as reduce the hassle of carrying around multiple ID cards for each program.
- Extends the Independence at Home program allowing an extra 5,000 high-need and high-risk Medicare beneficiaries to receive physician services in the home and avoid institutional care. The pilot program was introduced to test whether having nurses and doctors available for house calls can improve health care and reduce costs. Due to the early success of the program, the CHRONIC Care Act will also increase the length of the program from five years to seven years.
- Provides flexibility for chronically ill Medicare Advantage beneficiaries to experiment with different types of benefit packaging to find the right plan for their needs. Medicare Advantage plans in any state can participate at the start of 2020.
While the CHRONIC Care Act is a promising sign Medicare is changing for the better, the new laws barely skim the surface of what our aging population is going to need in the future.
Today’s seniors are living longer than ever before and in these later years many fall victim to severe disabilities like osteoporosis and frailty, dementia and Alzheimer’s, strokes and Parkinson’s. Looking into the 21st-century, we are faced with the challenge of how to orchestrate the necessary in-home care and assistance to help those who are struggling, to remain independent and lead fulfilling lives.