The U.S. Senate Finance Committee www.finance.com is interested in developing a package on chronic care for Medicare beneficiaries. In response, the American Telemedicine Association (ATA) www.americantelemed.org sent a letter on June 22, 2015 to the Senators listing several specific changes to allow telehealth services for chronic care patients under capitated or prospective payment systems. Some of the recommendations would also amend beneficiary access under fee-for-service payments.
Some of the key recommendations that would help to build Medicare improvements for chronic care include:
- New and growing Medicare models with value-based payments and team-based services such as the budget-saving CMS www.cms.gov Independence at Home Demonstration. The demo should be expanded and include a specific wavier of the telehealth prohibition for services to a beneficiary at home and also for beneficiaries in non-rural locations
- Tougher financial penalties for hospital readmissions now involving cardiac failure and beginning in October COPD. CMS should share savings with hospitals.
- Medicare coverage for monthly periods of physician management for beneficiaries with multiple chronic conditions
- To provide outpatient self-management training services specifically for patients with diabetes
- To increase CMS interest in coordinating Medicare and Medicaid coverage for people with above average incidence of either one or more chronic conditions
- To provide Medicaid “health homes” now operating in 19 states, the option to use telehealth for chronic care
- Permitting CMS to contract with entities to provide bundled and coordinated Medicare services for a specific long term illness, chronic medical conditions, or medical subspecialties
- Use remote patient monitoring data for the stage 3 “meaningful use” payment which should be strengthened, finalized, and started on schedule. Also, patients, families, and caregivers need to be able to use their personal devices to routinely contribute data to their longitudinal health records
- To improve flexibility for chronic care telehealth and other telehealth under capitated or prospective payments and improve beneficiary access under fee-for-service payments
Go to www.americantelemed.org/docs/default-source/policy/ata-letter-on-chronic-care-medicare-legislation.pdf?sfvrsn=4 to view ATA’s letter with details sent to the Senate Finance Committee.