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FOR IMMEDIATE RELEASE
July 25, 2019
Contact: Joann Donnellan
(703) 966-1990
[email protected] [mailto:[email protected]]

BPC Releases New Analysis Supporting Innovative Benefits for People With Ch=
ronic Conditions in Medicare Fee-For-Service

Washington, D.C.=C2=A0=E2=80=94 A new analysis released today by the Bipart=
isan Policy Center demonstrates that providing non-medical benefits, such a=
s home-delivered meals tailored to a targeted group of individuals with chr=
onic conditions in Medicare fee-for-service, could help avert hospital read=
missions. It also shows a possible savings of $1.57 per patient for every d=
ollar spent on the meals program. The analysis conducted by Ananya Health I=
nnovation is outlined in BPC=E2=80=99s new report, Next Steps in Chronic Ca=
re: Expanding Innovative Medicare Benefits [[link removed]
port/next-steps-in-chronic-care/], which provides recommendations on ways t=
o improve care for those with chronic conditions.

Watch the event webcast live at 10 a.m. ET:=C2=A0https://bipartisanpolicy.o=
rg/event/improving-care-for-individuals-with-complex-needs/=20

According to the Centers for Disease Control, Medicare beneficiaries with f=
our or more chronic conditions account for 90 percent of Medicare hospital =
readmissions and 74 percent of overall Medicare spending.
=C2=A0
=E2=80=9CThe proposals in our report create a fiscally responsible pathway =
for covering non-medical benefits in Medicare fee-for-service,=E2=80=9D sai=
d Katherine Hayes, BPC health policy director. =E2=80=9CThey would allow th=
e Secretary of Health and Human Services to authorize coverage of these ser=
vices if there is no net increase in Medicare spending.=E2=80=9D
=C2=A0
Today, two-thirds of people 65 and older are covered by traditional Medicar=
e fee-for-service compared to one-third who are enrolled in Medicare Advant=
age (MA) plans. Under the Bipartisan Budget Act (BBA) of 2018, Congress onl=
y provided authority for MA plans to offer special supplemental benefits fo=
r the chronically ill beginning in January 2020. The benefits include medic=
ally tailored home-delivered meals, non-medical transportation, home modifi=
cations, and other benefits that have a reasonable expectation of improving=
or maintaining a person=E2=80=99s health or function. BPC=E2=80=99s propos=
als support changing federal policy to extend these benefits to the sickest=
Medicare beneficiaries in fee-for-service. These services are especially c=
ritical in rural areas where MA plans are limited.
=C2=A0
=E2=80=9CThree in four Americans over age 65 are living with multiple chron=
ic conditions,=E2=80=9D said Hayes.=C2=A0=E2=80=9CGiven the high percentage=
of Medicare beneficiaries with chronic conditions, Congress should extend =
these benefits to those in Medicare fee-for-service and put safeguards in p=
lace to ensure the services are evidence-based, targeted, and do not result=
in an increase in beneficiary cost-sharing, premiums, or additional costs =
to taxpayers.=E2=80=9D
=C2=A0
Hayes also stressed that only those individuals who meet the criteria and r=
eceive care through accountable care organizations, primary care models, or=
chronic care management services would be eligible for the program.
=C2=A0
Ananya Health=E2=80=99s analysis is based on information in the 2016 Medica=
re Current Beneficiary Survey (MCBS) Public Use File. It identified patient=
s in the traditional Medicare program with two or more chronic conditions a=
nd at least one functional limitation such as bathing or eating, who could =
be eligible for the non-medical benefit. The benefit was seven days of medi=
cally tailored home-delivered meals post hospital discharge based on eviden=
ce that these meals can reduce readmission rates for patients with 11 diffe=
rent chronic conditions including congestive heart failure, stroke, diabete=
s, emphysema, Alzheimer=E2=80=99s disease, osteoporosis, and others.
=C2=A0
According to this simulation, full participation could lead to 575,408 elig=
ible beneficiaries, with 1,012,590 eligible inpatient stays, and 9,719 fewe=
r hospital readmissions due to the supplemental benefit. The aggregate cost=
for these beneficiaries would be $101,258,974 ($175.98 per person). The gr=
oss savings due to reduced readmission rates would be $158,606,687, resulti=
ng in a net savings of $57,347,713 or $1.57 per patient for every dollar sp=
ent on the meals program.
=C2=A0
In an effort to improve care for those with chronic conditions, BPC=E2=80=
=99s report also includes recommendations that provide greater authority to=
the Centers for Medicare and Medicaid Services (CMS) to better integrate a=
nd align services for people eligible for both Medicare and Medicaid. Addit=
ionally, it offers proposals to improve on the provisions in the BBA by cre=
ating more transparency around who qualifies for these special supplemental=
benefits. It also requires MA plans to make it easier for providers to uti=
lize the new benefits and report outcomes to CMS to help build an evidence =
base on the effectiveness of covered non-medical services.
=C2=A0
BPC plans to develop additional analyses on other non-health related benefi=
ts over the coming year including home modifications and non-medical transp=
ortation services.
=C2=A0
This report is supported by The Commonwealth Fund and The SCAN Foundation.
=C2=A0
Read the full report [[link removed]
onic-care/]
Read the Associated Press story on the report [[link removed]
40c9de34701a93792b6b8f46b84]

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eft:5px;padding-right:5px;">
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<tr>
<td style=3D"width:590px;vertical-align:top;background-=
color:transparent;"><table style=3D"width:590px;" width=3D"100%" border=3D"=
0" cellpadding=3D"5" cellspacing=3D"0"><tbody><tr><td id=3D"textOnlyTD" val=
ign=3D"top" align=3D"left"><div><font face=3D"Verdana" size=3D"2"><strong>F=
OR IMMEDIATE RELEASE</strong></font></div>
<div><font size=3D"2" face=3D"Verdana">August 21, 2019</font></div>
<div><font size=3D"2" face=3D"Verdana"></font><font face=3D"Verdana" size=
=3D"2">Contact: Joann Donnellan</font></div><div><font face=3D"Verdana" siz=
e=3D"2">(703) 966-1990</font></div>
<div><font size=3D"2" face=3D"Verdana"><a href=3D"mailto:jdonnellan@biparti=
sanpolicy.org">[email protected]</a></font></div>
<div><font face=3D"Verdana" size=3D"2"></font></div>
<div><font face=3D"Verdana" size=3D"2"></font></div>
<div><font face=3D"Verdana" size=3D"2"></font></div></td></tr></tbody></tab=
le></td>
</tr>
</table>
</td>
</tr>
<tr>
<td style=3D"padding-top:2.5px;padding-bottom:2.5px;padding-l=
eft:5px;padding-right:5px;">
<table cellpadding=3D"0" cellspacing=3D"0" border=3D"0" ali=
gn=3D"center">
<tr>
<td style=3D"width:590px;vertical-align:top;background-=
color:transparent;"><table style=3D"width:590px;" width=3D"100%" border=3D"=
0" cellpadding=3D"5" cellspacing=3D"0"><tbody><tr><td id=3D"textOnlyTD" val=
ign=3D"top" align=3D"left"><div><font color=3D"#e33b45"><strong><em><font f=
ace=3D"Georgia"><font size=3D"5"><strong style=3D"color: rgb(227, 59, 69);"=
><em><font face=3D"Georgia"><font size=3D"5">New BPC Report Calls for Expan=
ded Use of Real-World Evidence for Decision-Making on Drugs and Biologics</=
font></font></em></strong></font></font></em></strong></font></div></td></t=
r></tbody></table></td>
</tr>
</table>
</td>
</tr>
<tr>
<td style=3D"padding-top:2.5px;padding-bottom:2.5px;padding-l=
eft:5px;padding-right:5px;">
<table cellpadding=3D"0" cellspacing=3D"0" border=3D"0" ali=
gn=3D"center">
<tr>
<td style=3D"width:590px;vertical-align:top;background-=
color:transparent;"><table style=3D"width:590px;" width=3D"100%" border=3D"=
0" cellpadding=3D"5" cellspacing=3D"0"><tbody><tr><td id=3D"textOnlyTD" val=
ign=3D"top" align=3D"left"><div><i><font face=3D"Verdana" size=3D"2">Washin=
gton, D.C.</font></i><font face=3D"Verdana" size=3D"2"><font size=3D"2">=C2=
=A0=E2=80=94=C2=A0</font>Today, the amount of electronic health care data i=
s rapidly growing due to the widespread adoption of electronic health recor=
ds and the popularity of digital health tools, such as wearable devices, bi=
osensors, apps, and remote patient monitoring. A new <b style=3D"font-size:=
10pt;"><a href=3D"[link removed]
MDItYjE5MjMzLTZjYjYxNDdiM2QwNzRhNjI5ZGE1N2EzNWQ1Yjk4YzA4%3AYi5pZ2phY2tidWx3=
YXJrQGdtYWlsLmNvbQ%3AY29udGFjdC05YTYxNTJhMzdjYWFlOTExYTk3ZjAwMGQzYTE4Y2I0Ny=
04ZDEyNzMyOGExYjM0ZmNmODQ2Njk4NDk4ZDM5N2E3Nw%3AZmFsc2U%3AMQ%3A%3AaHR0cHM6Ly=
9iaXBhcnRpc2FucG9saWN5Lm9yZy9yZXBvcnQvZXhwYW5kaW5nLXRoZS11c2Utb2YtcmVhbHdvc=
mxkLWV2aWRlbmNlLWluLXJlZ3VsYXRvcnktYW5kLXZhbHVlLWJhc2VkLXBheW1lbnQtZGVjaXNp=
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4M1lYSnJRR2R0WVdsc0xtTnZiUSUzZCUzZCZyZWNpcGllbnRpZD1jb250YWN0LTlhNjE1MmEzN2=
NhYWU5MTFhOTdmMDAwZDNhMThjYjQ3LThkMTI3MzI4YTFiMzRmY2Y4NDY2OTg0OThkMzk3YTc3J=
nV0bV9zb3VyY2U9Q2xpY2tEaW1lbnNpb25zJnV0bV9tZWRpdW09ZW1haWwmdXRtX2NhbXBhaWdu=
PVByZXNzJTIwVXBkYXRlJTIwJTdDJTIwSGVhbHRoJTIwUHJvamVjdCZlc2lkPTM2MGYxMjRhLTQ=
zYzMtZTkxMS1hOTg4LTAwMGQzYTE4YzQyZQ&K=3D5NjQNj7WSu4DvXGJW_m8DA">report</a><=
/b> released by the Bipartisan Policy Center offers recommendations for lev=
eraging this data, while protecting patient privacy, to improve the Food an=
d Drug Administration (FDA) regulatory decision-making, as well as value-ba=
sed payment for drugs and biologics.</font></div><div><font face=3D"Verdana=
" size=3D"2"><br></font></div>
<div class=3D""><font face=3D"Verdana" size=3D"2">The report, developed und=
er the guidance of former FDA commissioners <b>Dr.</b> <b>Robert Califf</b>=
, <b>Dr. Andrew von Eschenbach</b>, and <b>Dr.</b> <b>Mark McClellan</b>, a=
nd former Senate Majority Leader <b>Dr.</b> <b>Bill Frist</b>, explains how=
these new data sources can help bring safe and effective therapies more qu=
ickly to patients by improving the evidence base for evaluating medical pro=
ducts and value-based payment arrangements. New medical products, including=
small molecule drugs and biologics, such as cell and gene therapies, are s=
howing great promise for patients with cancer, neurodegenerative diseases, =
and other diseases with no current cure.</font></div><div class=3D""><font =
face=3D"Verdana" size=3D"2"><br></font></div>
<div class=3D""><font face=3D"Verdana" size=3D"2">=E2=80=9CThe use of real-=
world data and evidence is expanding to inform the discovery, development, =
and delivery of new therapies for patients, but there are many steps we can=
take to accelerate progress=E2=80=9D said <strong>McClellan</strong>, foun=
ding director of the Duke-Margolis Center for Health Policy. =E2=80=9CReal-=
world data can provide the basis for badly needed additional evidence about=
the risks and benefits of many therapies, and which ones are best for part=
icular patients.=E2=80=9D</font></div><div class=3D""><font face=3D"Verdana=
" size=3D"2"><br></font></div>
<div class=3D""><font face=3D"Verdana" size=3D"2">=E2=80=9CWe are living in=
an age of remarkable scientific progress,=E2=80=9D said <b>von </b><strong=
>Eschenbach</strong>,=C2=A0 president of Samaritan Health Initiatives. =E2=
=80=9CIt is imperative that we support this progress by continually examini=
ng and improving the way we evaluate and bring new, effective therapies to =
patients as quickly as is safely possible. We believe our recommendations a=
re important steps toward reaching that goal.=E2=80=9D</font></div><div cla=
ss=3D""><font face=3D"Verdana" size=3D"2"><br></font></div>
<div class=3D""><font face=3D"Verdana" size=3D"2">The report points out tha=
t while considerable progress has been made in using real-world data, there=
is more to do. In response to the 21^st Century Cures Act, the F=
DA has been working to advance its real-world evidence program to support b=
oth pre-market evaluation and post-market approval study requirements. At t=
he same time, value-based payment arrangements have been a theme across man=
y policy proposals to improve the affordability of drugs and biologics, and=
participation in these arrangements by payers and manufacturers is on the =
rise.</font></div><div class=3D""><font face=3D"Verdana" size=3D"2"><br></f=
ont></div>
<div class=3D""><font face=3D"Verdana" size=3D"2">While regulatory and paym=
ent decision-making would greatly benefit from electronic data in hospitals=
and health systems, physician practices and clinics, laboratories, pharmac=
ies, radiology centers, health plans, registries, and with patients themsel=
ves, challenges remain.</font></div><div class=3D""><font face=3D"Verdana" =
size=3D"2"><br></font></div>
<div class=3D""><font face=3D"Verdana" size=3D"2">=E2=80=9CBringing new dat=
a sources to bear, while assuring patient privacy, can help us tackle the a=
ccessibility and affordability of drugs in an era of rising health care cos=
ts, declining life expectancies, and concerns about disparities in our heal=
th care system,=E2=80=9D said <b>Califf</b>, professor of medicine and card=
iology at Duke School of Medicine.=C2=A0</font></div><div class=3D""><font =
face=3D"Verdana" size=3D"2"></font><font style=3D"font-size: small;" face=
=3D"Verdana">=C2=A0 =C2=A0 =C2=A0 =C2=A0 =C2=A0 =C2=A0 =C2=A0 =C2=A0 =C2=A0=
=C2=A0 =C2=A0 =C2=A0 =C2=A0 =C2=A0=C2=A0</font></div>
<div class=3D""><font face=3D"Verdana" size=3D"2"><b>BPC=E2=80=99s recommen=
dations include: </b></font></div>
<ol><li><font face=3D"Verdana" size=3D"2">Congress should assure adequate f=
unding of real-world evidence activities by funding the FDA=E2=80=99s FY 20=
20 $60 million budget request for a new medical data enterprise.</font></li=
><li><font face=3D"Verdana" size=3D"2">FDA should develop and publish timel=
y guidance on real-world evidence. </font></li><li><font face=3D"Verdana" s=
ize=3D"2">The Department of Health and Human Services (HHS) should improve =
access to data to support real-world evidence needs by adopting electronic =
health information export and application programming interface (API) provi=
sions contained in recently released proposed rules, collaborating to devel=
op HL7 FHIR^=C2=AE implementation guides, and making both Medicar=
e data and mortality information more readily available.</font></li><li><fo=
nt face=3D"Verdana" size=3D"2">ONC should improve the reliability and relev=
ance of data by adopting the U.S. Core Data for Interoperability (USCDI)and=
requiring real-world testing of interoperability as a condition of certifi=
cation. </font></li><li><font face=3D"Verdana" size=3D"2">FDA should develo=
p guidance to accelerate the use of digital tools in the collection of data=
from patients to support the entire medical product development life cycle=
.</font></li><li><font face=3D"Verdana" size=3D"2">FDA should expand its ef=
forts to explore the utility of artificial intelligence to support real-wor=
ld evidence needs.</font></li><li><font face=3D"Verdana" size=3D"2">FDA and=
the Centers for Medicare and Medicaid Services (CMS) should expand and acc=
elerate pilot and demonstration projects to evaluate the use of real-world =
evidence generated from new data sources for the evaluation of both drugs a=
nd biologics=E2=80=94including cell therapies=E2=80=94for both regulatory a=
pproval and payment.</font></li><li><font face=3D"Verdana" size=3D"2">Congr=
ess should advance a federal data privacy framework that establishes baseli=
ne protections and addresses entities handling health information that are =
not covered under HIPAA to help assure privacy and confidentiality. Privacy=
policies should also take into account the real-world evidence needs of re=
gulatory evaluation and value-based payment arrangements.</font></li><li><f=
ont face=3D"Verdana" size=3D"2">FDA should continue to advance innovative, =
new models of drug development, including adaptive pathways that leverage r=
eal-world data. The FDA should also continue with its plans to create a new=
office of drug evaluation science.</font></li><li><font face=3D"Verdana" s=
ize=3D"2">HHS should create safe harbors to provide regulatory certainty re=
garding value-based payment arrangements and expand upon existing safe harb=
ors to enable donation or cost-sharing of software supporting real-world ev=
idence needs. </font></li><li><font face=3D"Verdana" size=3D"2"> Congress a=
nd HHS should expand and support the CMS workforce to support evaluation of=
new emerging therapies, as well as the implementation of value-based payme=
nt arrangements for drugs and biologics.</font></li><li><font face=3D"Verda=
na" size=3D"2"> <font size=3D"2">CMS and the FDA should increase collaborat=
ion on the generation and use of real-world evidence to support both value-=
based payment and regulatory evaluation needs. Public and private sector st=
akeholders should also work together to advance collaborative models of evi=
dence development that bridge current silos.</font></font></li></ol>
<div><font face=3D"Verdana" size=3D"2"><strong><a href=3D"[link removed]
kdimensions.com/c/4/?T=3DMTE3NDM3Mzc%3AMDItYjE5MjMzLTZjYjYxNDdiM2QwNzRhNjI5=
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br></div><div><font face=3D"Verdana" size=3D"2">"Congress and HHS have laid=
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------=_Part_1317301398_2037457580.1566396264236--

------=_Part_1317301397_1204642413.1566396264236--

FOR IMMEDIATE RELEASE
July 25, 2019
Contact: Joann Donnellan
(703) 966-1990
[email protected] [mailto:[email protected]]

BPC Releases New Analysis Supporting Innovative Benefits for People With Chronic Conditions in Medicare Fee-For-Service

Washington, D.C. — A new analysis released today by the Bipartisan Policy Center demonstrates that providing non-medical benefits, such as home-delivered meals tailored to a targeted group of individuals with chronic conditions in Medicare fee-for-service, could help avert hospital readmissions. It also shows a possible savings of $1.57 per patient for every dollar spent on the meals program. The analysis conducted by Ananya Health Innovation is outlined in BPC’s new report, Next Steps in Chronic Care: Expanding Innovative Medicare Benefits [[link removed]], which provides recommendations on ways to improve care for those with chronic conditions.

Watch the event webcast live at 10 a.m. ET: [link removed]

According to the Centers for Disease Control, Medicare beneficiaries with four or more chronic conditions account for 90 percent of Medicare hospital readmissions and 74 percent of overall Medicare spending.
 
“The proposals in our report create a fiscally responsible pathway for covering non-medical benefits in Medicare fee-for-service,” said Katherine Hayes, BPC health policy director. “They would allow the Secretary of Health and Human Services to authorize coverage of these services if there is no net increase in Medicare spending.”
 
Today, two-thirds of people 65 and older are covered by traditional Medicare fee-for-service compared to one-third who are enrolled in Medicare Advantage (MA) plans. Under the Bipartisan Budget Act (BBA) of 2018, Congress only provided authority for MA plans to offer special supplemental benefits for the chronically ill beginning in January 2020. The benefits include medically tailored home-delivered meals, non-medical transportation, home modifications, and other benefits that have a reasonable expectation of improving or maintaining a person’s health or function. BPC’s proposals support changing federal policy to extend these benefits to the sickest Medicare beneficiaries in fee-for-service. These services are especially critical in rural areas where MA plans are limited.
 
“Three in four Americans over age 65 are living with multiple chronic conditions,” said Hayes. “Given the high percentage of Medicare beneficiaries with chronic conditions, Congress should extend these benefits to those in Medicare fee-for-service and put safeguards in place to ensure the services are evidence-based, targeted, and do not result in an increase in beneficiary cost-sharing, premiums, or additional costs to taxpayers.”
 
Hayes also stressed that only those individuals who meet the criteria and receive care through accountable care organizations, primary care models, or chronic care management services would be eligible for the program.
 
Ananya Health’s analysis is based on information in the 2016 Medicare Current Beneficiary Survey (MCBS) Public Use File. It identified patients in the traditional Medicare program with two or more chronic conditions and at least one functional limitation such as bathing or eating, who could be eligible for the non-medical benefit. The benefit was seven days of medically tailored home-delivered meals post hospital discharge based on evidence that these meals can reduce readmission rates for patients with 11 different chronic conditions including congestive heart failure, stroke, diabetes, emphysema, Alzheimer’s disease, osteoporosis, and others.
 
According to this simulation, full participation could lead to 575,408 eligible beneficiaries, with 1,012,590 eligible inpatient stays, and 9,719 fewer hospital readmissions due to the supplemental benefit. The aggregate cost for these beneficiaries would be $101,258,974 ($175.98 per person). The gross savings due to reduced readmission rates would be $158,606,687, resulting in a net savings of $57,347,713 or $1.57 per patient for every dollar spent on the meals program.
 
In an effort to improve care for those with chronic conditions, BPC’s report also includes recommendations that provide greater authority to the Centers for Medicare and Medicaid Services (CMS) to better integrate and align services for people eligible for both Medicare and Medicaid. Additionally, it offers proposals to improve on the provisions in the BBA by creating more transparency around who qualifies for these special supplemental benefits. It also requires MA plans to make it easier for providers to utilize the new benefits and report outcomes to CMS to help build an evidence base on the effectiveness of covered non-medical services.
 
BPC plans to develop additional analyses on other non-health related benefits over the coming year including home modifications and non-medical transportation services.
 
This report is supported by The Commonwealth Fund and The SCAN Foundation.
 
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