Another plus for the new Medicare bill

New Medicare Law Boosts to Chronic Care

The goal of this heightened monitoring is to prevent a medical crisis that could send the patient to the hospital. Such coordinated care for people with chronic illnesses such as diabetes, heart disease and high blood pressure is the focus of disease management programs, which got a big boost in the Medicare law signed by President Bush last week. It is these patients who consume most health care dollars.

The government hopes to enroll as many as 400,000 older people with chronic conditions in these programs. By involving the patient, physicians, pharmacists and other providers in commonsense steps to improve patient health, the government seeks to limit costly hospital stays.

“We want to prevent diabetics from becoming dialysis patients,” said Rep. Nancy Johnson, R-Conn., a leading supporter of including disease management in Medicare.

The chronic care effort, plus a new Medicare physical and other preventive screenings, are a marked change in the 38-year-old government health care program for 40 million older and disabled Americans. Traditionally, Medicare has paid for treating illnesses, not preventing them.

But the number of Medicare beneficiaries with chronic conditions is large and growing, said Mark Miller, executive director of the federal Medicare Payment Advisory Commission.

Three-fourths of Medicare beneficiaries have at least one chronic condition, and close to one-third have four or more, Miller told a recent congressional forum. These people account for 80 percent of Medicare spending.

Such numbers make the benefit of early intervention indisputable, said Health and Human Services Secretary Tommy Thompson. “It is better for us to start managing diabetes, hypertension, asthma and other conditions before they get exacerbated,” Thompson said. “It will save us money in the long run.”

While as always, the devil is in the details, this benefit seems quite promising. I have used disease management with CHF and believe that it provides an outstanding addition to care.