Home care and hospice won a double victory yesterday, September 26, when the United States Senate passed the CHRONIC Care Act and the RAISE Family Caregivers Act. Both pieces of legislation are important to the home care and hospice community and the millions of Americans who depend on it. The National Association for Home Care and Hospice (NAHC) worked hard to ensure passage of the legislation in the Senate and we will be working hard to get the legislation moved forward in the House of Representatives.
The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S.870), will reduce Medicare costs by improving chronic disease management services and care coordination at home.
The legislation will increase access to telehealth for Medicare patients with chronic illnesses and create incentives for patients to receive care via accountable care associations (ACOs). The bill would also extend the Independence at Home (IAH) demonstration to allow people to remain in their homes rather than in institutionalized settings. The Act would also permit reimbursement for more social services and non-health, and permanently extend the MA Special Needs plans that assist chronically ill patients.
Ranking member Ron Wyden (D-OR) noted during a hearing on the bill last May that seniors suffering from more than two chronic conditions simultaneously (such as heart disease and diabetes) account for more than 90 percent of Medicare spending. Reforming health care policy to better serve seniors with chronic illnesses is “premier challenge of American health policy.”
A major advantage of the CHRONIC Care Act, according to Wyden, is that it allows more care to be provided at home and with an emphasis on primary care and non-physician providers. Wyden also emphasized the need for people with chronic illnesses to have an advocate to help “guide them through what can be a teeth-gnashing experience of navigating American health care.”
“This is a formal recognition that this package of services - the focus on care at home, the focus on new technology, the expanded role for primary care and prevention, which inevitably leads to more non-physician providers - is the beginning of our push to update the Medicare guarantee,” Senator Wyden told Medpage Today. “That's why it's transformative."
• Implement the federal Commission on Long-Term Care’s bipartisan recommendation that Congress require the development of a national strategy to support family caregivers.
• Create an advisory body to bring together relevant federal agencies and others from the private and public sectors to advise and make recommendations.
• Identify specific actions that government, communities, providers, employers, and others can take to recognize and support family caregivers and be updated annually.
The legislation is based on a recommendation by the bipartisan Commission on Long-Term Care to develop a national plan to support family caregivers.
Similar legislation is pending in the House of Representatives and NAHC is asking members of the home care and hospice community to ask their Representative to support H.R. 3759. NAHC recently wrote a Dear Representative letter to all House member offices urging co-sponsorship of the RAISE Family Caregivers Act (H.R. 3759).
The role of family caregivers is crucial in caring for many seniors and disabled individuals in their homes. The most recent estimates show about 40 million family caregivers in the United States provided approximately 37 billion hours of care to adults in 2013, according to a report released by the AARP’s Public Policy Institute. The estimated economic value of the unpaid contributions of family caregivers was about $470 billion in 2013, up from approximately $450 billion in 2009.
However, the ratio of potential family caregivers to the growing number of older people is in a precipitous decline. In 2010, there were seven potential caregivers available for each person 80 or older; by 2030 there will be only four, and by 2050, when baby boomers are between 86 and 104, there will be fewer than three.
Caring for an elderly or disabled relative carries a financial toll, both in terms of lost income and additional expenses. Those who care for people with Alzheimer’s disease typically spend more than $50,000 a year on expenses related to their duties. Developing a national plan to help care for the elderly and disabled is critical to the nation’s long-term fiscal and healthcare future, as well as a powerful moral imperative. By supporting family caregivers we help people stay out of hospitals and nursing homes and remain in their homes, which is where they want to be. This will save money for both families and taxpayers.
MHCA and NAHC are pleased with Senate passage of these two important pieces of legislation. It is a further sign that MHCA, NAHC, and the entire home care and hospice community is having a major policy impact on this Congress. We intend to continue succeeding for the more than 12 million Americans who rely on home care and hospice.