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How the CHRONIC Care Act Changes Medicare for the Chronically Ill

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How the CHRONIC Care Act Changes Medicare for the Chronically Ill


Updated: March 15, 2019    Published: July 6, 2018

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Despite all the good Medicare does in the hospital, Medicare is known for leaving home needs unfilled.

Older adults who live with chronic illnesses – such as arthritis, diabetes, and cancer – are challenged by these non-medical needs on a daily basis. Doctors have new tools to address chronic but non-medical needs as of February 2018, now that Congress has passed and signed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act.

The CHRONIC Care Act addresses daily health needs by increasing the range of support your Medicare can provide. The law particularly expands care for Medicare beneficiaries living with long-term health issues.

Medicare’s well-intentioned coverage rules limit payments for non-medical equipment and have been long in need of an update. These rules have caused individuals to needlessly suffer from accidents and difficult living conditions.

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What’s In the CHRONIC Care Act?

The new law includes multiple solutions to improve integrated care for people with Medicare, or both Medicare and Medicaid. We’ve highlighted the main parts of the legislation to give you a better understanding of the act:

Coverage for Non-Medical Costs: For individuals with chronic illnesses, non-medical equipment can be just as effective as prescription medications and other health treatments. Starting in 2020, Medicare Advantage plans can choose to cover costs for certain items, such as wheelchair ramps and bathroom grab bars, that prevent future accidents and help you manage daily tasks.

With the CHRONIC Care Act, Medicare Advantage plans can also cover additional targeted expenses for those with specific illnesses. These benefits include a range of alternative therapies, from fitness to counseling, to better your health.

Expansion of Telehealth: Folks with chronic disorders may have more care questions compared to the average patient. Telehealth services – programs which give help over phone, video, and emerging technologies – are a tool for Medicare enrollees get personalized attention faster.

As technology plays an increasing role in our healthcare system, telehealth allows for quick and affordable doctor-patient communication. The CHRONIC Care Act gives Medicare Advantage plans more flexibility to design telehealth programs that keep you out of the doctor’s office.

'If the only way to get your question answered is to plop yourself down in the doctor's office and potentially be exposed to things like flu - it's not good.' -Dr. Bruce Chernof, President of The SCAN Foundation, on more telehealth. Click To Tweet

Support From Accountable Care Organizations (ACOs): Chronically ill patients are often burdened by the financial costs of doctor’s visits, creating more barriers to health resources.

Now, with this new law, certain Accountable Care Organizations (ACOs) can offer monetary incentives – up to $20 per visit – for patients to receive primary care. ACOs include doctors and hospitals who offer Medicare patients high-quality services. With this change, which is already common in some health insurance plans for younger folks, you’ll have an easier time seeking professional help when needed.

Independence at Home (IAH) Extension: The Independence at Home program provides primary care in the homes of Medicare beneficiaries with chronic disorders. With IAH, medical professionals visit patients’ homes to accommodate travel expenses. With the CHRONIC Care Act, IAH will expand its course to offer this home-based service to more individuals. 15,000 people nationwide will benefit from IAH through September 2019.

The Politics of the CHRONIC Care Act

The CHRONIC Care Act was introduced in December 2016. The bill came to fruition from the help of patients, doctors, healthcare professionals, and advocacy groups, convincing politicians to make changes to the sensitive Medicare program. Later, the bill was unanimously passed by both Republicans and Democrats in the Senate. On February 9, the final bill was enacted and signed by the President as a part of the Bipartisan Budget Act of 2018.

The act won support from across the ideological spectrum in the Senate – an example of public health concern trumping politics. Congress has acknowledged the difficulties and barriers of those with special requirements due to chronic disorders. Washington has a general awareness of how important it is to keep Medicare standards up-to-date.

By improving the efficiency of professional medical care, legislators hope to see better health for the chronically ill older generations.

Taking the Next Steps

Once you turn 65, you’re able to apply for Medicare online. You can enroll in Medicare Advantage during this time or during Medicare’s Annual Election Period, which runs from October 15 through December 7 every year. Though the CHRONIC Care Act’s changes to Medicare Advantage do not take effect until 2020, you can still begin to think about your coverage in the future.

By learning about the different parts of Medicare, you can choose the best plan to fit your needs. Chronic illnesses can limit you  from your day-to-day activities. The CHRONIC Care Act is an encouraging sign that more holistic support and care is coming, and it will ultimately help disease management.

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