From Joann Donnellan <[email protected]>
Subject New BPC Report: Improving America's Health Requires a "Health in All Policies" Approach to Federal Policymaking
Date August 22, 2019 2:07 PM
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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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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 22, 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>
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eft:5px;padding-right:5px;">
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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: Improving Amer=
ica's Health Requires a "Health in All Policies" Approach=C2=A0</font></fon=
t></em></strong></font></font></em></strong></font></div></td></tr></tbody>=
</table></td>
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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 size=3D"2" face=3D"Verdana">=C2=A0=E2=80=94 Impr=
oving population health in the United States requires a shared responsibili=
ty by all federal governmental agencies to apply a Health in All Policies (=
HiAP) approach to decision-making. That's the message of a new <a href=3D"h=
ttp://elink.clickdimensions.com/c/4/?T=3DMTE3NDM3Mzc%3AMDItYjE5MjM0LWU1YTEw=
MzNlMjE2YzQzOTNhMDZhNThhMWU2NDFiYWNm%3AYi5pZ2phY2tidWx3YXJrQGdtYWlsLmNvbQ%3=
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2Y2FiMmEyJnV0bV9zb3VyY2U9Q2xpY2tEaW1lbnNpb25zJnV0bV9tZWRpdW09ZW1haWwmdXRtX2=
NhbXBhaWduPVByZXNzJTIwVXBkYXRlJTIwJTdDJTIwSGVhbHRoJTIwUHJvamVjdCZlc2lkPTEyO=
TRkOTEzLWE2YzItZTkxMS1hOTg4LTAwMGQzYTE4YzQyZQ&K=3DFRVfUhoWhDY841oBPlHsZw">r=
eport</a> released today by the Bipartisan Policy Center which provides rec=
ommendations on ways to incorporate health considerations, such as mitigati=
ng the impact of social determinants of health, across all levels of federa=
l policymaking to improve health outcomes.</font></div>
<div><font size=3D"2" face=3D"Verdana">=C2=A0</font></div>
<div><font size=3D"2" face=3D"Verdana">"While the United States spends more=
on health care than any other developed nation, Americans have worse healt=
h outcomes in many areas," said=C2=A0<strong>Anand Parekh</strong>,=C2=A0<s=
trong>M.D.</strong>, BPC chief medical advisor. "Federal policies have a pr=
ofound influence on the way people live their lives."</font></div>
<div><font size=3D"2" face=3D"Verdana">=C2=A0</font></div>
<div><font size=3D"2" face=3D"Verdana">Today the majority of what makes us =
healthy and unhealthy results from our environment, education, socioeconomi=
c status, and behavior. Beyond clinical services, where we live, work, and =
play are important factors that influence our health. However, most of thes=
e factors are not directly influenced by federal health agencies such as th=
e U.S. Department of Health and Human Services (HHS). While HHS has large r=
esponsibilities in advancing the nation's health, other federal agencies pl=
ay a significant role.</font></div>
<div><font size=3D"2" face=3D"Verdana">=C2=A0</font></div>
<div><font size=3D"2" face=3D"Verdana">"Many of the drivers and determinant=
s of poor health in the United States are preventable," said Parekh. "Howev=
er, social determinants of health cannot be addressed by any one federal ag=
ency or within the four walls of a doctor's office or hospital. it will tak=
e forging multi-sector partnerships to work toward the common goal of impro=
ving population health."</font></div>
<div><font size=3D"2" face=3D"Verdana">=C2=A0</font></div>
<div><font size=3D"2" face=3D"Verdana">BPC's report examines how three exec=
utive branch departments, including the U.S. Department of Education (ED), =
U.S. Department of Treasury (Treasury), and U.S. Department of Labor (DOL),=
currently implement a HiAP strategy and provides ways to build on these ef=
forts to improve health outcomes.</font></div>
<div><font size=3D"2" face=3D"Verdana">=C2=A0</font></div>
<div><font size=3D"2" face=3D"Verdana">The report encourages all executive =
branch departments to adopt a HiAP approach to policymaking when feasible. =
It also recommends that the current administration could build on the prior=
administration's National Prevention Strategy, which was developed by 17 f=
ederal departments to prioritize=C2=A0health and quality of life for all Am=
ericans. Alternatively, the current administration could support a similar =
health in all policies approach in the following ways:</font></div>
<div><font face=3D"Verdana" size=3D"2"><font size=3D"2" face=3D"Verdana"><f=
ont size=3D"2"></font>
</font>
</font>
<ol><li><font size=3D"2" face=3D"Verdana">The Office of Management and Budg=
et could ask that departments integrate HiAP approach into their quadrennia=
l strategic plans as well as their annual budget submissions.</font></li><l=
i><font face=3D"Verdana" size=3D"2">The Office of Information and Regulator=
y Affairs within the Office of Management and Budget could require departme=
ntal regulatory proposals to include health impact assessments.</font></li>=
<li><font face=3D"Verdana" size=3D"2"><font face=3D"Verdana"></font>The Whi=
te House Domestic Policy Council could convene leaders from select departme=
nts to establish a HiAP council. HHS could provide technical assistance to =
the council regarding the determinants of health and evidence-based policie=
s that support them.</font></li></ol>
</div>
<font face=3D"Verdana" size=3D"2">
<font size=3D"2">"Taking these steps could spark a more robust and comprehe=
nsive strategy across the executive branch," added=C2=A0<strong>Bill Hoagla=
nd</strong>, BPC senior vice president. "Working together, policymakers acr=
oss all sectors of the federal government have the potential and the opport=
unity to improve the health outcomes of the nation."</font>
</font>
<div><font size=3D"2" face=3D"Verdana">=C2=A0</font></div>
<div><font size=3D"2" face=3D"Verdana"><strong><a href=3D"[link removed]
kdimensions.com/c/4/?T=3DMTE3NDM3Mzc%3AMDItYjE5MjM0LWU1YTEwMzNlMjE2YzQzOTNh=
MDZhNThhMWU2NDFiYWNm%3AYi5pZ2phY2tidWx3YXJrQGdtYWlsLmNvbQ%3AY29udGFjdC05YTY=
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MTFhOTdmMDAwZDNhMThjYjQ3LTE3Njk5YWRmMTg1NzQ4M2ViMTExNzZkOTE2Y2FiMmEyJnV0bV9=
zb3VyY2U9Q2xpY2tEaW1lbnNpb25zJnV0bV9tZWRpdW09ZW1haWwmdXRtX2NhbXBhaWduPVByZX=
NzJTIwVXBkYXRlJTIwJTdDJTIwSGVhbHRoJTIwUHJvamVjdCZlc2lkPTEyOTRkOTEzLWE2YzItZ=
TkxMS1hOTg4LTAwMGQzYTE4YzQyZQ&K=3DQHlepx8st7zsyZF1-IUlvQ">=E2=80=8BRead the=
report</a></strong><br>
</font></div>
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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 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.
 
Read the full report [[link removed]]
Read the Associated Press story on the report [[link removed]]

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