Introduction

Last year, the United States Senate Committee on Finance (Committee) took its first step in an important initiative to improve care for the millions of Americans managing chronic illness. On July 15, 2014, the Committee held a hearing entitled, “Chronic Illness: Addressing Patients’ Unmet Needs.” Senators heard compelling testimony from individuals battling multiple chronic medical conditions who are seeking more effective tools to help them navigate today’s complex health care system. Senators also heard from providers, employers, and health plans about the challenges each face in trying to offer higher quality care at lower cost.

From August through October, the working group studied all 530 stakeholder comments and conducted 80 stakeholder meetings to discuss ideas that improve the way care is delivered to Medicare beneficiaries with chronic diseases. In reviewing all submissions, the working group outlined three main bipartisan goals that each policy under consideration should strive to meet:

1. The proposed policy increases care coordination among individual providers across care settings who are treating individuals living with chronic diseases;

2. The proposed policy streamlines Medicare’s current payment systems to incentivize the appropriate level of care for beneficiaries living with chronic diseases; and

3. The proposed policy facilitates the delivery of high quality care, improves care transitions, produces stronger patient outcomes, increases program efficiency, and contributes to an overall effort that will reduce the growth in Medicare spending.

As the working group spent time with a wide variety of stakeholders to discuss policies submitted in response to the Committee’s request, several broad themes began to emerge. However one overarching issue was clear: developing and implementing policies designed to improve disease management, streamline care coordination, improve quality, and reduce Medicare costs is a formidable challenge. While we are committed to tackling this urgent matter head on, the Committee has repeatedly stated its intention to proceed thoughtfully.

Blogger comment:

I read the 30 pages as I do all committee actions issued out of the Congress to tell us how to do our job in 30 to 1,000 pages of academics with no mention of anything but how it will save money and improve their yet to be published esoteric definition of quality.  Not a word about how to pay for this and who will be the judge of quality outcomes when we haven’t yet defined them.

If you want to be bewildered like I am go to www.chronic_care@finance.senate.gov  because all I see is cutting Medicare costs by having Medicare Advantage (the insurance companies cutting off the payment after so many days … certainly not 100).  So the conclusion is providers are at fault so pay them less and expect more and they will fix the problem … which I believe to be intolerant Governing.  Again the solution is for the private sector to stand up for themselves and define the quality measures for Chronic Care and what it will cost to restore their functioning before it becomes our fault.