Senate committee advances bill that expands telehealth access for chronically ill Medicare patients

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On Thursday, a Senate committee advanced a bill that Sen. Orrin Hatch says "will improve disease management, lower Medicare costs and streamline care coordination services" for Medicare beneficiaries.

The Senate Finance Committee on Thursday advanced a bill aimed at improving care quality and coordination for Medicare recipients, in part by allowing greater use of telehealth.

The Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2017, also known as CHRONIC, sailed through the committee after a unanimous vote.

The bill, said Committee Chairman Orrin Hatch, R-Utah, “will improve disease management, lower Medicare costs and streamline care coordination services—all with bipartisan solutions and without adding to the deficit.”

Here’s a look at some of the key provisions:

For ACOs:

  • It lets Medicare accountable care organizations expand the use of telehealth services, specifically in their own homes
  • It allows Medicare fee-for-service beneficiaries to voluntarily identify an ACO professional as their primary care provider. In certain cases, an ACO can also choose to have Medicare fee-for-service beneficiaries assigned prospectively, rather than retrospectively
  • It creates an ACO Beneficiary Incentive Program “to encourage Medicare fee-for-service beneficiaries to obtain medically necessary primary care services”

For Medicare Advantage:

  • Starting in 2020, it allows providers to supply additional supplemental benefits to chronically ill patients, provided they “have a reasonable expectation of improving or maintaining the health or overall function” of that enrollee
  • It permits MA plans in all states to test value-based insurance design payment models
  • It changes some of the regulations surrounding Medicare Advantage special needs plans, particularly in regard to how they manage and coordinate care
  • It lets MA plans expand the telehealth benefits that they offer beneficiaries, when clinically appropriate

The bill would also extend the Independence at Home demonstration, expand access to home dialysis therapy and expand the use of telehealth for stroke patients.

So far, the legislation has received a relatively warm reception from healthcare industry and interest groups.

“We are grateful to the Senate Finance Committee and the Chronic Care Working Group for its commitment to improving the care of Medicare beneficiaries with chronic conditions,” Alliance of Community Health Plans President and CEO Ceci Connolly said in an emailed statement.

However, she urged senators to “reconsider language in the bill that may be unnecessarily limiting to the capabilities and reach of telehealth services so that we can work together to improve health and lower costs.” Connolly also wanted to see changes to the bill’s language on quality star ratings.

The Better Medicare Alliance, though, was even more laudatory, with President and CEO Allyson Schwartz saying that the bill “builds on Medicare Advantage’s framework to offer even greater opportunity for flexibility and innovation in benefits and care delivery to address one of the most important challenges in Medicare: The care of those individuals with multiple chronic conditions.”