Policy & Regulation News

AMGA to Reps: Pass CHRONIC Care Act to Aid ACOs, Team-Based Care

House Representatives should pass the CHRONIC Care Act to advance chronic disease management in ACOs and promote team-based care, AMGA stated.

CHRONIC Care Act, accountable care organizations, and team-based care

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By Jacqueline LaPointe

- AMGA recently pushed House Representatives to pass the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, which would particularly support accountable care organizations (ACO) implementing chronic disease management.

Senators unanimously passed the CHRONIC Care Act in September 2017. House Representatives are now reviewing the bill’s proposals to enhance Medicare reimbursement to providers delivering chronic disease management and care coordination services.

The bill includes several proposes including extending the Independence at Home demonstration, expanding access to home dialysis treatment, permitting states to create benefits to meet the needs of costly patients, reimbursing providers for telehealth services, and improving chronic disease management capabilities of ACOs.

Changes specific to ACOs in the Medicare Shared Savings Program (MSSP) Track 1 would allow the organizations to request to have their attributed patient populations assigned prospectively. ACOs would then receive attributed beneficiaries at the start of the performance year rather than at the end.

Knowing which patients are assigned to the ACO beforehand may help the organizations to meet the needs of chronic disease patients and better understand the financial risk of their attributed population.

The Senate-approved bill would also waive the originating site requirement for telehealth services for MSSP ACOs in downside financial risk tracks. Patient homes would be added as a qualifying originating sites and geographic limitations would be eliminated when ACOs deliver telehealth services to assigned patients.

Additionally, the bill as it currently stands would permit MSSP ACOs to give incentive payments to attributed patients who receive qualifying primary care services. Policymakers designed the incentive payments to encourage Medicare beneficiaries to seek medically necessary services.

AMGA backed the MSSP changes detailed in the CHRONIC Care Act, stating that the policy proposals promote chronic disease management and team-based care.

The trade association also supported provisions in the bill that would authorize the creation of special needs plan and expansion of supplemental benefits to chronically ill beneficiaries in the Medicare Advantage space as well as extending and increasing the scope of the Independence at Home demonstration.

“Care coordination is extremely important for those with chronic illnesses and diseases,” stated Jerry Penso, MD, MBA, AMGA President and CEO. “AMGA members, many who participate in our programs focused on chronic care such as Together 2 Goal, are implementing team-based care processes that lead to better, coordinated, care, yet more can be done. The improvements included in the CHRONIC Care Act would provide clinicians with the tools needed to enhance care for the chronically ill. We urge the House to act swiftly and pass the bipartisan CHRONIC Care Act.”

Despite support from healthcare stakeholders and the Senate, experts fear that the extensive CHRONIC Care Act may have trouble passing the House.

Smaller, tailored bills that aim to advance specific policies included in the CHRONIC Care Act may have more of a chance in the House.

AMGA also backed several of these smaller bills that cleared the House Energy and Commerce Committee. Specifically, the association commended the committee for advancing the FAST Act of 2017, which would increase the scope of the originating site definition to locations where stroke evaluations can occur. Providers would be able to receive reimbursement for telehealth services for stroke patients.

AMGA also applauded the House committee for advancing H.R. 3263, a bill that would extend the Independence at Home program, and H.R. 3727, which would permit Medicare Advantage plans to include comprehensive telehealth benefits by 2020.