From the President

Back in May, I testified before the Senate Special Committee on Aging on behalf of legislation that would significantly improve the care that millions of older adults receive -- the Geriatric Assessment and Chronic Care Coordination Act (GACCCA) of 2007. This watershed legislation would bridge a major gap in Medicare by authorizing coverage of geriatric assessments and care coordination for beneficiaries with multiple chronic conditions.

Comprehensive multiple disease care management and coordination are integral to quality care for older patients with multiple chronic health problems, and the American Geriatrics Society (AGS) has been working closely with Sens. Blanche Lincoln (D-AK) and Susan Collins (R-ME), who introduced the bill in the Senate, and with Reps. Gene Green (D-TX) and Fred Upton (R-MI), who introduced it in the House. Both chambers were considering the legislation, and AGS had just launched a major advocacy campaign to raise awareness of and support for the act, as this issue of AGS News went to press. GACCCA would affect a vast number of Medicare beneficiaries. More than 60% of beneficiaries have two or more chronic conditions and almost 20% have five or more.

It's no surprise to those of us in the field that a comprehensive evaluation that results in a coordinated care plan can improve both the quality and the cost-effectiveness of care. So can having a care coordinator, such as a physician, nurse practitioner, or physician's assistant, oversee implementation of the care plan by the healthcare providers involved, the patient, and his or her caregivers - the "chronic care team."

Research confirms that care coordination boosts quality of care, improves health outcomes and reduces healthcare costs for those with chronic conditions. As a result of this holistic, coordinated approach, fewer hospital visits are needed, duplicative services and appointments are eliminated, and sudden health crises are avoided. When a comprehensive geriatric assessment is combined with coordinated care, studies have shown even better outcomes.

GACCCA would not only improve care for older adults and enhance cost-effectiveness throughout the Medicare system, it could also help make geriatrics more viable.

As we all know, Medicare doesn't pay physicians or other healthcare providers to coordinate their activities with others - by, for example, offering extensive family and patient telephone consultation, monitoring medication effects or overseeing transitional care as frail older patients move among different settings. As a result, a growing number of our colleagues are finding themselves unable to both provide such holistic, patient-centered care and sustain their practices.

The Geriatric Assessment & Chronic Care Coordination Act would apply to traditional fee-for-service Medicare insurance - in which about 85% of beneficiaries are enrolled. It would cover geriatric assessments for beneficiaries whose medical costs rank in the top 10% of all Medicare beneficiaries' and who also have multiple chronic health problems, or dementia and at least one other chronic condition. Under the Act, beneficiaries who qualify for a geriatric assessment and who would benefit from care coordination could opt for that service, choose a chronic care manager and meet with the care manger to develop a comprehensive care plan. Components of care coordination would include management of and referral to medical and other health services; medication monitoring and management; education and counseling for the patient and family caregivers; self-management services; and management of transitions among professionals and settings of care.

Long overdue, GACCCA got off to a fast start when it was introduced in the House of Representatives and the Senate on the same day as the Senate hearing. GACCCA has already won the endorsement of 33 national organizations including the American College of Physicians, the American College of Nurse Practitioners, the National Association of Social Workers and the National Rural Health Association. We hope it will also win the endorsement of Congress. There is still a long way to go before GACCCA becomes law. Please help us sustain the momentum and urge your legislators to support GACCCA by taking a few minutes to join the AGS Health in Aging Advocacy Center's campaigns on behalf of this legislation and other initiatives supporting quality healthcare for older people. Simply visit www.healthinaging.org/advocacy/ and sign up to get emailed alerts of these campaigns. All it takes is a few minutes and a few keystrokes.