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  • Washington Highlights

    Senate Finance Hearing on Chronic Conditions

    Len Marquez, Senior Director, Government Relations

    The Senate Finance Committee May 14 held a hearing titled, “A Pathway to Improving Care for Medicare Patients with Chronic Conditions.”

    Chairman Orrin Hatch (R-Utah) began the hearing by raising concerns about the staggering costs to treat chronically ill patients in the Medicare system, but recognized that “developing and implementing new policies designed to improve disease management, streamline care coordination, improve quality, and reduce Medicare costs is a daunting challenge.”

    Sen. Hatch noted the hearing was the first bipartisan step to address the issue in the next six months, and announced that he and Ranking Member Ron Wyden (D-Ore.) appointed Senators Johnny Isakson (R-Ga.) and Mark Warner (D-Va.) to chair a new Finance Committee chronic care reform working group.

    Sen. Hatch then explained the committee will issue a formal invitation requesting all interested public and private sector stakeholders to submit ideas on ways to improve outcomes for Medicare patients with chronic conditions, with the goal of producing bipartisan legislation by the end of the year.

    Ranking Member Wyden echoed similar concerns regarding Medicare spending and cited care coordination as a foundational element in addressing the issue stating, “Congress needs to make life easier for providers who want to coordinate care, whether that’s more information about patients, improved access to innovative technology, or other measures that promote flexibility. At the same time, accountability is critical to ensure providers are successfully treating patients while also producing savings from coordinating care.”

    Centers for Medicare and Medicaid Services Chief Medical Officer Patrick Conway, M.D., and Medicare Payment Advisory Commission (MedPAC) Executive Director Mark Miller, Ph.D., testified.

    Sen. Robert Menendez (D-N.J.), focused his questioning on MedPAC’s recommendation regarding the Hospital Readmission Reduction Program (HRRP), asking Dr. Miller, “Given what we know about the link between multiple chronic conditions and lower socioeconomic status, it’s reasonable to assume what we sometimes call the frequent flyer population, accounting for nearly all hospital readmissions, are also of lower socio-economic status. Research has shown that 77 percent of hospitals that treat a disproportionate share of lower income beneficiaries were penalized under the HRRP.”

    Dr. Miller explained the commission’s recommendation stating, “When you measure readmissions, you should not readjust in such a way that the disparities are hidden. Disparities should stay present because we should be focused on trying to correct them; poor people should get good care as well.”

    Dr. Miller added, “The penalty should be moderated depending on the amount of poor people you have in a hospital. You stratify hospitals into categories based on the percentage of people who are poor and then adjust the penalty in a way that is less aggressive for the poorer hospitals than hospitals with fewer poor. Within your category, you still have pressure to improve.”

    Sen. Menendez then asked the status of the implementation of that proposal, to which Dr. Miller replied, “That’s in the hands of the Congress.”