Medicare Benefits for the Chronically Ill

Congress and the Trump administration are revamping Medicare to provide extra benefits to the people with multiple chronic illnesses, which is definitely different from the program’s typical focus which aims to create a new model of care for millions of American seniors.

The changes made which are reflected in both a new law, in official guidance from the Department of Health and Human Services, tackle a troublesome issue in health care: how to deal with long-term illnesses that can compound on one another, in addition to the social factors outside the reach of traditional medicine that can contribute to them (e.g. food, transportation, and housing, etc.).

The additional benefits being added can include social and medical services, home improvements (e.g. wheelchair ramps), transportation to doctors’ offices, and deliveries of hot meals to the home.

The new law is a bipartisan cooperation on a majority policy initiative, which has been embraced by members of Congress from both parties. The changes are also supported by Medicare officials, as well as insurance companies operating the Medicare Advantage plans, currently service one-third of the 60 million Medicare beneficiaries.

One reason for updating Medicare in this manner is to cater to seniors with chronic conditions, allowing them to receive care at home, which in turn will enable them to stay independent and out of the hospital.

About half of Medicare patients are treated for multiple chronic conditions, and they account for three-fourths of Medicare spending. Under the new law and policy, most of the added benefits will be applied to Medicare Advantage plans, which can offer additional benefits tailored to the needs of people with diabetes, Parkinson’s disease, Alzheimer’s, heart failure, some types of cancer, rheumatoid arthritis, among other similar chronic conditions.

It is the hope of many that combining social and medical services will produce better outcomes for patients, while simultaneously saving money for Medicare.

Original Article taken from the August 2018 edition of the EJL Medicare Advisors eNewsletter
Authored by Robert Pear
Original wording edited for reposting purposes