WASHINGTON--(BUSINESS WIRE)--Please replace the release with the following corrected version due to multiple revisions.
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COALITION TO PROMOTE INDEPENDENCE IN MEDICARE ENDORSES GRASSLEY-CARDIN BILL TO HELP OLDER AMERICANS STAY IN THEIR HOMES FOR CARE
A consortium of 14 leading healthcare organizations today strongly endorsed bipartisan legislation put forth by Sens. Chuck Grassley (R-IA) and Ben Cardin (D-MD) to allow frail older Americans to receive individualized care in their own homes rather than in a nursing home.
The Coalition to Promote Independence in Medicare, comprised of providers, health plans, and other health industry leaders, is urging legislators to include the Community Based Independence for Seniors Act (S. 704) in the next Medicare reform legislation.
Peter Begans, senior vice president of SCAN Health Plan, a coalition member, noted that a great deal of attention has been spent in recent years on improving care for individuals who are eligible for both Medicare and Medicaid, which is “fantastic, because duals are some of the nation’s highest cost and most poorly served patient populations. But wouldn’t it be great to intervene earlier and help nursing home-eligible Medicare patients before they spend down their limited assets and have to go on Medicaid? That is what the Community Based Independence for Seniors Act is all about.”
“Sens. Grassley and Cardin have crafted an approach that makes sense and provides value for both seniors and taxpayers,” said Coalition member Mary Grealy, president and CEO of the Healthcare Leadership Council. “Medicare Advantage plans have expertise in meeting the needs of older Americans who have seen their health struggles increase with age. Let’s use those resources to help these seniors stay in their own homes, which they prefer, and not be forced into more expensive institutionalized care, saving tax dollars. ”
Fellow Coalition member Donald Crane, president and CEO of CAPG, thanked Sens. Grassley and Cardin “for introducing legislation that will allow more physician groups to care for low-income, frail Medicare beneficiaries in their homes, where many beneficiaries prefer to receive their care.”
The coalition pointed out that today the federal government does not pay for long-term services and support unless an individual is poor enough to be on Medicaid. What frequently happens is that seniors on Medicare go into a nursing home, spend down their assets, and then go on Medicaid for their long-term care. The Grassley-Cardin bill would help prevent this from happening by establishing a new Community-Based Institutional Special Needs Plan (CBI-SNP) demonstration program that would provide for home- and community-based services for low-income, Medicare-only beneficiaries who need help with two or more activities of daily living, the usual criteria for nursing home eligibility.
“A few simple things – like a bathtub bar or a personal aide – can keep seniors in their own home longer and avoid expensive nursing home stays. But current rules that ban the use of Medicare dollars for that purpose often force seniors into nursing homes and drive up taxpayer costs in Medicaid,” said Coalition member John Rother, president and CEO of the National Coalition on Health Care. “This legislation takes the first step toward correcting that. Congress shouldn’t wait to put this common sense idea into action.”
Under Grassley-Cardin, the new demonstration would operate in up to five states initially and build upon Medicare Advantage plans that have experience caring for this frail population. The demonstration would generate evidence to support an alternative payment methodology that could produce savings for both states and the federal government. One study estimates four-year savings of nearly $60 million for a demonstration of 5,000 Medicare members by postponing or preventing hospitalization and institutionalization.
“The Visiting Nurse Associations of America thanks Sens. Grassley and Cardin for allowing older Americans and their families a choice in where they receive their medical care,” said Coalition member Tracey Moorhead, president and CEO of VNAA. “Home-based care providers, such as VNAA’s members, offer quality-driven low-cost care to individuals and their communities and will play a key role in this demonstration program.”
Grassley and Cardin said the legislation will give hope to some of the nation’s most vulnerable individuals and at the same time offer a path toward state and federal budget savings. The Grassley-Cardin bill will be assigned to the Finance Committee, with jurisdiction over Medicare and Medicaid.
Members of the Coalition to Promote Independence in Medicare include ArchCare, CAPG, Care Wisconsin, Commonwealth Care Alliance, Express Scripts, Health Partners, Healthcare Leadership Council, LeadingAge, Maxim Health, the National Coalition on Health Care, Population Health Alliance, SCAN Health Plan, SNP Alliance and the Visiting Nurse Associations of America.
