In a Jan. 26 letter to the to the Senate Finance Committee’s bipartisan Chronic Care Working Group, the AAMC commends the committee’s continuous efforts in improving care for Medicare patients with chronic conditions. The AAMC’s letter highlights that accountability measures used in hospital and physician reporting or performance programs need to be appropriately risk adjusted to account for socio-demographic statuses.
To improve care for patients with multiple chronic conditions, the AAMC supports the payment for a new high-severity chronic care management code as a recognition of the additional time and effort needed to coordinate the care of these types of patients. However, the association believes measures should be taken to avoid creating new codes similar to existing codes. Furthermore, the methodology that is used to identify patients with multiple chronic conditions should be appropriately risk adjusted to account for the complexity of the patient’s care.
The AAMC supports many of the suggestions to provide patient-centered care, including allowing the home to be an originating site for hemodialysis. In addition, the association supports the provision of items and services, such as meals, transportation, support groups to talk and socialize, and testing or training for job skills to a wide range of patients. The association does not support limiting these items and services to patients with a chronic disease and a behavioral disorder, as the working group proposed.
Finally, the AAMC supports the ability for Accountable Care Organizations (ACOs) to expand telehealth services. According to the association’s letter, a process should be established for either upside or two-sided risk ACO models to receive a waiver of the geographic component of the originating site requirement for telehealth services. Additionally, regulatory barriers should be appropriately reduced and appropriate reimbursement incentives should be adopted to encourage collaboration for coordinated patient care.
Last year, the Senate Finance Committee held two hearings that initiated a transparent, long-term discussion with key stakeholders to better understand the concerns affiliated with caring for chronic care patients [see Washington Highlights May 15, 2015]. To get additional feedback, the committee issued its first paper, which received 530 policy recommendations from various organizations. As a part of its continued bipartisan efforts, the committee seeks to determine which proposals need increased attention by requesting feedback on the specific areas drafted in the committee’s second paper, which was released on Dec. 18, 2015.