New York Estate Planning & Elder Law Blog
Senators are currently hosting a series of hearings that are focused on the need to improve Medicare for seniors that are suffering from chronic illness. Two senators, Mark Warner and Johnny Isakson, have been tasked with developing specific proposals for bills that would help this section of the elderly population pay for and treat their chronic illnesses under the Medicare system and have gotten others involved in actively suggesting reforms for the program.
Seniors with Chronic Illness
Seniors suffering from chronic illness is a serious problem in the Medicare system. Currently, about fourteen percent of Medicare recipients have at least six or more chronic conditions. This subgroup of consumers represents almost half of the Medicare program’s costs. Another cost driver is that these seniors also often have other functional limitations or cognitive impairment that can also increase the cost of care that most of the other seniors in the program without chronic illness do not have.
According to a study done by the Urban Institute, Medicare spends on average about $16,000 per person suffering from chronic illnesses and other forms of impairments. This is nearly twice as much as the average elder enrolled in Medicare or enrollee that had chronic illness but did not have other impairments. The additional cost comes from hospital care, skilled nursing facilities, and other personal assistance needs.
Proposed Ideas for Reform
Thankfully, a number of medical professionals and others have been present at the hearings put on by the Senate and have proposed ideas for Medicare reform. One proposal involved the creation of Affordable Care Organizations. In this new system, doctors and hospitals would create financial arrangements to treat episodes of chronic illness for a fixed Medicare price.
Bundled payments, where medical service providers would combine services and payment in a less structured environment than the Affordable Care Organizations was also proposed as another option for chronic illness care. However, there are other ideas out there to reform the Medicare system that were not proposed at the Senate hearings.
Other Options for Reform
One idea to reform the Medicare program for patients suffering from chronic disease is called the Medicaring Accountable Care Model. This program would combine medical and social services into a single comprehensive care plan. Massachusetts has already enacted a Medicare Advantage plan similar to this model for seniors with special needs called “senior care options.” It has successfully combined medical services with home supportive services.
It has become clear that the best options for treating Medicare patients suffering from chronic diseases would combine payments and treatments in addition to social services. These seniors need improved medical care, social support, and personal assistance at home or in a facility as well as better access to services. However, the current Senate hearings aimed at reforming this part of the Medicare system are a good start to helping this section of the elderly population.