The U.S. Senate on Tuesday evening unanimously passed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, bipartisan legislation that would expand telehealth services for chronic care patients in Medicare.
The legislation (S.870), introduced in April by Sens. Orrin Hatch (R-Utah), Ron Wyden (D-Ore.), Mark Warner (D-Va.), Johnny Isakson (R-Ga.), and others, has the overarching goal to transform how Medicare works for seniors who suffer from chronic illnesses by including provisions such as expanding access to telehealth services. Currently, there are several restrictions regarding reimbursement for telehealth services under Medicare, such as patients may only be located at certain clinical sites or within certain rural areas and only Medicare-defined physicians and practitioners can provide telehealth services.
“This bill marks an important step towards updating and strengthening Medicare’s guarantee of comprehensive health benefits for seniors,” Senator Wyden, the ranking Democrat on the Senate Finance Committee, said in a statement.
“Medicare policy cannot stand idly by while the needs of people in the program shift to managing multiple costly chronic diseases,” Wyden said. “This bill provides new options and tools for seniors and their doctors to coordinate care and makes it less burdensome to stay healthy.”
Under Title III of the bill, expanding innovation and technology, there are several provisions related to enhanced telehealth access and use, including: increasing convenience for Medicare Advantage enrollees through telehealth, providing accountable care organizations (ACOs) the ability to expand the use of telehealth, and expanding the use of telehealth for individuals with stroke.
Providing ACOs the ability to expand the use of telehealth services is an especially noteworthy component of the legislation, as most existing Medicare reimbursement policies only cover limited telehealth services. Specifically, however, this bill calls for the inclusion of the home as an originating site for telehealth services and for no application of geographic limitations. However, eligible ACOs in this provision must take on two-sided risk.
The CHRONIC Care Act now goes to the House of Representatives.
As previously reported by Healthcare Informatics Managing Editor Rajiv Leventhal, the Congressional Budget Office (CBO) graded the bill favorably in its preliminary cost estimate, noting that expanding telehealth to the home for Medicare dialysis treatment would be budget neutral. Also of note, expanding the use of telestroke would add about $180 milling to spending over the next decade, while adding telehealth to ACOs will cost some $100 million, per the agency’s estimations. But, CBO estimated, savings would be seen by increasing convenience for Medicare Advantage enrollees via telehealth ($80 million) and by eliminating the Medicare and Medicaid Improvement Funds ($375 million). This is the first time that CBO has scored telemedicine legislation since 2001.
