Dive Brief:
- Approximately 70% of the 54 million Medicare beneficiaries take part in fee-for-service plans. In an attempt to improve care coordination for this population, the Obama administration has passed legislation to pay providers for coordinating care for patients with multiple chronic conditions.
- Doctors, nurse practitioners and other providers will be paid $42 a month to assess patients' holistic needs, ensure they are adhering to medication regimens, monitor care of specialists and ensure transitions between care providers. Under the new legislation, patients will pay for 20% of the monthly fee.
- Participating physicians will be required to draft a plan of care for each patient taking part. The physicians will also have to be available to the patients 24 hours a day, seven days a week for urgent chronic care needs.
Dive Insight:
The fee is not a large one, but the legislation is just one more step in the movement toward payment for care that is already being performed by many providers, but not reimbursed. Movement toward a value-based system will pose opportunities for things like telehealth, disease prevention and chronic care management.
With the 24-hour requirement for care, the Obama administration is sending a clear message that these patients must be well-managed on a regular basis. There is opportunity for systems working with primary care providers to take part in this kind of program, but it will take creative staffing efforts dedicated to this population.