In a June 22 letter to the Senate Finance Committee’s bipartisan chronic care working group, AAMC President and CEO, Darrell Kirch M.D., commended Chairman Senate Orrin Hatch (R-Utah), Ranking Member Ron Wyden (D-Ore.), and Sens. Johnny Isakson (R-Ga.) and Mark Warner (D-Va.) for their “efforts to improve care for Medicare patients with chronic conditions by establishing a bipartisan working group.”
The working group, chaired by Sens. Isakson and Warner, was seeking comment on policies to improve care coordination for Medicare patients [see Washington Highlights, May 15].
The letter highlights that care for patients with multiple chronic illnesses is often fragmented, and suggests that “maintaining a single locus for as much care as is appropriate is an important goal.” The letter continues, “Incentives aligned across providers are key to achieving this end. It is important to design a system that avoids redundant care, conflicting management advice, and high costs and inconvenience that result from poorly coordinated care.”
To improve coordinated chronic care solutions, the AAMC suggests the committee incorporate policies that focus on: collaboration and communication across different providers and care settings; clarity and accountability across health care teams; aligning incentive and rules across all alternative payment model programs (APMs) that a patient may qualify for; and appropriately risk adjusting for complex patients to ensure accurate measurement.
The letter specifically addresses four of the eight areas sought by the senators regarding:
- Transformative policies that improve outcomes for patients living with chronic diseases either through modifications to the current Medicare Shared Savings Accountable Care Organization (ACO) Program, piloted APMs currently underway at the Centers for Medicare and Medicaid Services (CMS), or by proposing new APM structures;
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Reforms to Medicare’s current fee-for-service program that incentivize providers to coordinate care for patients living with chronic conditions;
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The effective use, coordination, and cost of prescription drugs; and
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Ideas to effectively use or improve the use of telehealth and remote monitoring technology.