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by Amanda Conschafter, blog editor

January 26 ended the public comment period for the U.S. Senate Finance Committee’s chronic care working group policy options paper—cueing the group’s legislative efforts to begin in earnest. Released in December, the paper explores how to improve care for Medicare beneficiaries with chronic illnesses.

The working group’s paper tackles several broad policy issues:


Telehealth receives considerable attention in the draft. “Telehealth may have the potential to replace some face-to-face office visits, reduce emergency room visits, and prevent hospitalizations,” the working group members note. As chronic conditions are best managed through ongoing monitoring, telehealth applications can reduce seniors’ need for constant trips to health care facilities and minimize transportation challenges.

The value of telehealth has already led some legislators to propose broadening access for Medicare patients. Last year’s Medicare Telehealth Parity Act, for example, would increase the range of clinicians who qualify as telehealth providers. Under the bill, respiratory therapists could serve patients suffering from chronic conditions such as COPD, providing guidance on oxygen utilization and ensuring medication adherence. The bill would also allow certified diabetes educators could to support Medicare patients with diabetes. It remains to be seen whether legislation stemming from the finance committee’s efforts will incorporate similar provisions.

Independence at Home

In another move to facilitate care outside traditional settings, the paper suggests making Medicare’s Independence at Home demonstration project permanent. An effort of the Centers for Medicare and Medicaid Services’ Innovation Center, the demonstration explores the care and cost benefits of having health care providers deliver “comprehensive primary care services” in patients’ homes. The demonstration began June 1, 2012, the policy paper notes, and is scheduled to end September 30, 2017.

The working group’s paper reflects a seven-months-long process, during which the group reportedly received 530 comments and conducted 80 meetings with stakeholders. According to the committee’s website, members will now weigh public comment on the policy options paper to “aid the committee in producing a bipartisan legislative product.”

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