December 5, 2003 Medicare Chronic Care Improvement Program
MEDICARE REFORM PROVISIONS FOR EHEALTH-BASED CHRONIC CARE PROMISE HIGHER QUALITY AT LOWER COST, EHEALTH LEADERS SAY
Mountain View, CA and Washington, D.C. – December 5, 2003 – Unpublicized provisions of recently enacted Medicare reform point the way to technology-based Chronic Care Improvement programs playing a major role in improving healthcare for seniors while controlling costs, eHealth industry leaders said today. Chronic Care Improvement programs involve proactive monitoring of patients with chronic diseases, ranging from heart failure to diabetes to depression, to ensure patients’ conditions do not deteriorate to the point where emergency-room visits or long hospital stays are needed. The results are improved quality of life and often dramatically lowered healthcare costs. In-home monitoring technologies play an important role in these programs by providing health professionals with timely information on patients’ clinical status. These technologies also educate patients and empower them to better manage their health.
The Medicare reform package, to be signed Monday by President George W. Bush, will broaden significantly the use of Chronic Care Improvement programs and technology in the traditional Medicare fee-for-service program. Chronic Care Improvement programs are also mandatory in Medicare Advantage, a new Medicare managed care option. The federal Centers for Medicare and Medicaid Services estimates that in 1996, 12.1 percent of Medicare patients accounted for 76 percent of Medicare spending, largely due to repeated hospital admissions for patients with chronic diseases such as congestive heart failure, diabetes, and chronic obstructive pulmonary disease.
“The impact of the chronic care provisions quietly included in this bill may be as important to the future of Medicare as the highly publicized drug benefit,” said Molly Coye, M.D., CEO of the non-profit Health Technology Center. “Chronic care that incorporates information systems and patient monitoring will improve the quality of care and drive down costs.”
The new law requires the Health and Human Services Secretary to develop and evaluate Chronic Care Improvement programs over three years, starting in 2004. A broader program would be rolled out in 2007 if such programs continue to show strong results in improving clinical outcomes and containing costs. The law requires Chronic Care Improvement programs to include the “… use of monitoring technologies that enable patient guidance through the exchange of pertinent clinical information, such as vital signs, symptomatic information, and health self-assessment.” It also requires chronic care providers to use patient databases and decision-support tools.
“The way we are going to create a sustainable healthcare system given the aging population is to start paying for chronic care improvement, rather than waiting for the crises that are the consequences of unmanaged chronic disease,” said Steve Brown, CEO of Health Hero Network, which develops technology solutions for Chronic Care Improvement combining home health monitoring and self-care education for patients. “These provisions of the Medicare bill are a vital first step toward modernizing and improving one of our most important public services.”
Inclusion of the Chronic Care Improvement provisions in the final Medicare reform bill was also supported by the Information Technology Association of America. “The better, more widespread application of information technology in healthcare can realize the dream of moving services closer to the home, increasing quality and access and reducing costs,” ITAA President Harris Miller said.
Janet Marchibroda, CEO of the eHealth Initiative, a multi-stakeholder consortium of over 140 organizations whose mission is to improve healthcare quality and safety through information, pointed to studies indicating that technology-based Chronic Care Improvement demonstration projects have reduced hospital admissions by as much as 63 percent (Virtually Healthy: Chronic Disease Management in the Home, Disease Management, 2002, 5(2): 87-94).
“Numerous projects have shown that models of care embracing eHealth technologies, including remote patient monitoring and decision-support systems for doctors and hospitals, can enable better quality of care, improved patient safety, and reduced hospitalizations,” Marchibroda said. “Overall, this translates into better health care for all Americans and holds promise for stemming the dramatically rising costs of medical care.”
