Category Archives: General

Better Care, Lower Cost Act- A Good Use of Home Health Providers

Earlier this month, new legislation, the Better Care, Lower Cost Act was introduced in Congress. The bill is bi-partisan and sponsored by Senators Ron Wyden (D-OR) and Johnny Isakson (R-GA), and Congressmen Erik Paulsen (R-MN) and Peter Welch (D-VT).  The goal of this legislation is to improve chronic care management within the Medicare benefit. The legislation encourages the formation of multidisciplinary care teams to focus specifically on caring for patients in need of coordinated chronic care management.

The Better Care, Lower Cost Act proposes to create Better Care Programs (BCPs). BCPs would be required to provide all Medicare benefits, including physician visits, in-patient hospital care, diagnostic tests, post-acute care, hospice, and prescription drugs as well as perform health and functional assessments of each beneficiary and create individual care plans for each beneficiary. BCPs would receive risk-adjusted monthly capitated payments for each BCP enrolled Medicare beneficiary. BCP’s would be eligible to share in the Medicare savings generated through their efforts and earn additional bonuses based on their meeting specific quality criteria. They would also be responsible for any losses incurred should the cost of care be in excess of the monthly payment received.

Additionally, the bill envisions the creation of Chronic Care Innovation Centers (CCICs). The mission of CCICs is to research, design and implement strategies to improve the quality of chronic care management across payer types while developing best practices for caring for the chronically ill. It encourages medical education reform by requiring medical schools and residency training programs to develop evidence-based approaches for promoting team-based chronic care with emphasis on the integration of technological advancements into that care. Last, it places greater emphasis on meeting the chronic care management needs of rural and underserved communities.

We at Pyramid Home Health Services believe the infrastructure required to deliver quality Home Health services is exactly the same as will be required to build the foundations of these Better Care Programs (BCP) as contemplated in the Better Care, Lower Cost Act. More than 75% of current Medicare Home Health beneficiaries are living in the community setting with four or more chronic conditions. Accordingly, Home Health providers already have extensive experience assisting in the management of the health of some of America’s most chronically ill citizens. Home Health providers actively partner with physicians daily to bring better coordinated and technologically enabled care into the homes of patients in rural and underserved areas all across the country; and, last but certainly not least, home health is the absolute least costly venue of care in which to manage these patient’s conditions.

Where improving the delivery of chronic care management is concerned, comprehensive discharge planning, deployment of at home interventions, use of evidence-based treatment guidelines, on-going patient education on disease management and self- care and the promotion of collaborative care among health care providers is the key to success; this is also the core function of existing, quality home health providers. Much consideration has gone into the creation of new initiatives like financial alignment demonstrations that establish “Healthcare Homes” as model care management concepts within Medicare and Medicaid. Perhaps as the conversation surrounding the potential establishment of BCPs’ as articulated in the proposed Better Care, Lower Cost Act ensues, the innate benefits of building the same using existing home health infrastructure  as the BCP backbone will cause more thought to be given to the idea that the beneficiaries actual home can also be their healthcare home.

Pyramid Home Health Services is a provider of Home Health, Community Based Long-Term-Care, Hospice and Pharmacy services in Missouri. We have the clinicians, technology and experience required to assist you to improve the health of your patients and beneficiaries living at home with chronic illness. If you would like to discuss working together please call us at 888-880-6565 or visit us at www.pyramidhhs.com.