The Geriatric Assessment & Chronic Care Coordination Act

What is the Geriatric Assessment and Chronic Care Coordination Act (GACCCA) of 2007? Why is GACCCA so important? What is AGS' role in this legislation? What is the current status of the GACCC Act of 2007? (2/13/08) How many organizations have signed-on in support of GACCCA?

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What is the Geriatric Assessment and Chronic Care Coordination Act (GACCCA) of 2007?

• GACCCA will create a patient-centered approach under Medicare that will benefit patients with multiple chronic conditions and lower their healthcare utilization rates.
• The measure provides for a new Medicare benefit for geriatric assessment and care coordination services.
• Specifically, the Geriatric Assessment and Chronic Care Coordination Act of 2007 would authorize Medicare coverage of two services that many seniors currently lack.
  • The first is a geriatric assessment, which is a comprehensive evaluation of an individual's condition and a plan to keep the person healthy.
  • The second is coordination of medical care for individuals who have multiple chronic conditions, including dementia.

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Why is GACCCA so important?

• Currently, 20% of Medicare beneficiaries have five or more chronic conditions and account for 70% of Medicare spending.
• Geriatric assessment and care coordination services are essential to the care of these older adults.
• Studies have shown that healthcare expenditures for this population can be reduced, quality of care improved, and health outcomes enhanced when care is delivered in a coordinated fashion. When a comprehensive geriatric assessment is combined with coordinated care, studies have shown improved or stabilized function, reduced mortality, and changed patterns of healthcare utilization.
• Currently, the Medicare program does not pay healthcare providers for care coordination. Instead, physicians are paid only for episodic face-to-face care, not the continuous care, occurring both during and between visits, that is required to effectively manage multiple chronic conditions.

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What is AGS' role in this legislation?
AGS has worked with Congressional staff in the House and Senate on new language for the bipartisan GACCC Act of 2007 (S. 1340/ H.R. 2244). Sens. Blanche Lincoln (D-AR) and Susan Collins (R-ME) introduced the legislation in the Senate May 9, 2007. Senate cosponsors of the bill are: Barbara Boxer (D-CA), Robert Casey (D-PA), Hillary Rodham Clinton (D-NY), John Kerry (D-MA), Herb Kohl (D-WI), Barbara Mikulski (D-MD), Sherrod Brown (D-OH), Sheldon Whitehouse (D-RI) and Tom Carper (D-DE). Representative Gene Green (D-TX) and Fred Upton (R-MI) introduced the companion measure in the House. House cosponsors are: Representatives Tom Allen (D-ME), Dan Boren (D-OK), Bobby Jindal (R-LA), Earl Blumenaur (D-OR), Barney Frank (D-MA), Jim Marshall (D-GA), Jan Schakowsky (D-IL) and Joe Sestak (D-PA). AGS President Todd Semla, MS, PharmD, testified at a hearing before the Senate Special Committee on Aging the day the legislation was introduced.

"Providers have increasingly recognized the need for care coordination to properly manage the health of individuals with complex and multiple chronic health conditions," Dr. Semla noted. "Care coordination puts the patient at the center of care. The bill's establishment of a geriatric assessment and chronic care coordination benefit under Medicare's fee-for-service program will improve the care received by the frailest and most vulnerable patients in the Medicare population. It also will improve the lives of family caregivers by providing them the resources to better care for their parents, grandparents, brothers and sisters."

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What is the current status of the GACCC Act of 2007?

• A GACCCA-based demonstration project is currently under consideration for inclusion in the draft of Medicare legislation being prepared by the Senate Finance Committee. Given budget constraints and debates in Washington over spending bills, however, it is hard to predict whether we will see the GACCC demonstration project approved in this session.

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How many organizations have signed-on in support of GACCCA?
In addition to AGS there are thirty-four other organizations supporting the GACCC Act of 2007 and one that supports the demonstration project, including:

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