What does Medicare not cover?
Well, if you are a chronic illness patient for whom a co-payment comes at the likely cost of sacrificing an essential item, the very program that could positively impact your quality of life: chronic care management (also known as CCM).
But that may soon change.
Medicare's CCM program (Get new CPT code qualifications list) has provided multiple benefits for chronic illness patients since 2015, including reductions in hospitalizations and supplemental patient care between visits. But barriers remain for the needed inclusion of those on a fixed, low Social Security income. An $8 per month co-pay can mean choosing between their health and necessities for many of these patients.
But H.R.4755, known as Seniors' Chronic Care Management Improvement Act, was reintroduced—after being set aside due to Covid—to remove patient cost-sharing responsibility for CCM services.
Only 1 in 10
It is not surprising that only 684K patients out of the 35M Medicare beneficiaries have enrolled and benefited from CCM services (AAMC, 2021).
Under current rules, patients share costs for CCM the same way they do with other services covered by Medicare Part B. However, this component factors heavily in the patient's decision to decline CCM services because they cannot afford them.
Legislators say the benefits of hope to offset the costs for the individuals, knowing that CCM, which incentivizes preventative care, has proven to benefit national healthcare costs.
"By investing a few extra dollars a month through the Seniors Improvement Act, we ultimately save the taxpayers and seniors money while simultaneously providing a higher standard of care," said Rep. Jeff Duncan.
What We Can Do
Here at Vital Health Links, we believe that this is a crucial step toward meaningful patient-centered care by removing financial obstacles for every deserving patient.
We have seen the CCM program enable our care coordinator to provide high-quality care, including:
—Help reduce unnecessary hospital admissions,
—Reduce medication co-pay
—Connect patients better with their physicians
—Reduce food insecurity
—Navigate the vaccination process,
—and reduce social isolation.
Removing cost-sharing from the CCM program has broad implications towards improving patients' health and reducing the nationwide cost of care.
Therefore, we are asking for your help in supporting this critical legislation. Click Here to contact your representative, stating by phone, letter, or email, "I support H.R.4755, known as Seniors' Chronic Care Management Improvement Act."
You can find a summary of the legislation here.