Legislation Would Create Medicare Pilot Program To Expand At-Home Services For Some Beneficiaries With Chronic Conditions

Main Category: Medicare / Medicaid / SCHIP
Article Date: 02 Oct 2008 - 8:00 PST

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Sen. Ron Wyden (D-Ore.) and Rep. Edward Markey (D-Mass.) have introduced legislation (S 3613, HR 7114) that would create a three-year Medicare demonstration project in 26 states that aims to expand at-home services for some beneficiaries with multiple chronic health conditions, CQ HealthBeat reports. Eligible beneficiaries would include those who have functional impairments, two or more chronic illnesses and recent use of other health services.

Under the bill, participating physicians or nurse practitioners would collaborate with beneficiaries to develop a comprehensive care plan. The legislation also includes minimum performance standards for health outcomes and would measure the satisfaction level of beneficiaries, caregivers and providers. The bill would require providers to demonstrate savings of at least 5% annually compared to the cost of serving non-participating Medicare beneficiaries with chronic health problems. Providers would be able to keep 80% of the savings as an incentive for participation.

According to Wyden and Markey, the legislation would generate savings by improving beneficiaries' care and by reducing duplicative and unnecessary health care costs, CQ HealthBeat reports. Wyden added that the bill would "create incentives for providing patients with care options that offer greater independence and quality of life" (Anderson, CQ HealthBeat, 9/30).

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