Welch introduces bipartisan legislation to improve health care for seniors

Rep. Peter Welch today introduced bipartisan, bicameral legislation aimed at providing better care at lower cost for the millions of Medicare beneficiaries with multiple chronic conditions.  The bill builds on the success of the Vermont Blueprint for Health, a chronic disease initiative that improves health outcomes through prevention efforts and better coordination of care for Vermonters with chronic illness while reducing unnecessary costs.

The Better Care, Lower Cost Act would improve care coordination for beneficiaries with multiple chronic conditions, the most-expensive and fastest-growing portion of the Medicare population. The legislation would expand the use of multidisciplinary health teams to keep patients as healthy as possible in their homes and communities.   It is sponsored in the House by Welch and Rep. Erik Paulsen (R-MN), and in the Senate by incoming Senate Finance Committee Chair Sen. Ron Wyden (D-OR) and Sen. Johnny Isakson (R-GA).

According to Centers for Medicare and Medicaid Services, 68 percent of Medicare enrollees have multiple chronic conditions, and account for 93 percent of Medicare spending. Additionally, 98 percent of costly hospital readmissions involved beneficiaries with multiple chronic conditions.

“It is essential that we do a better job coordinating health care services for seniors suffering from chronic diseases.  Every day, these seniors struggle to navigate a maze of health care providers, too often on their own.  This bill, built on Vermont’s successful Blueprint for Health, will encourage providers to coordinate care and reward them for achieving healthy outcomes rather than for  the number of services they provide.  It’s a common sense solution that is long overdue.”

The legislation creates the “Better Care Program,” allowing health plans and groups of providers to form “Better Care Plans” or “Better Care Practices,” (BCPs) respectively. This program would be voluntary and open to Medicare enrollees suffering with chronic illnesses. Participating plans and practices would receive newly calculated risk-adjusted, capitated payments rewarding better health outcomes for enrolled beneficiaries.  

BCPs would be allowed to focus and specialize in chronic care delivery and management. Under current law, the so-called “attribution rule” strictly limits the ability of provider-led organizations to reach out to sicker patients and provide them with the highest-quality, integrated chronic care services.  

Additionally, the bill would encourage medical schools to focus on team-based care as well as geriatrics and chronic disease management.

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