AGS Commends CMS Proposed Medicare Payment Policies to Improve Care for the Chronically Ill

New York (July 12, 2016)—The American Geriatrics Society (AGS) commends the Centers for Medicare and Medicaid Services (CMS) for continuing to support improved payment for services provided to Medicare beneficiaries with multiple chronic conditions as part of the 2017 Medicare Physician Fee Schedule Proposed Rule. As a result of ongoing advocacy from the AGS and other specialties, CMS has proposed making payment for a number of services provided to chronically ill older adults—changes which dramatically improve current payment for chronic care management and management of people transitioning from hospital care to the home.

These proposals, which will take effect in 2017 if finalized, recognize much of the cognitive work that geriatrics healthcare professionals, primary care providers, and other cognitive specialists currently and regularly provide—until now without reimbursement—to those with chronic and acute illnesses. We thank CMS for recognizing the value and importance of this care and believe that it will dramatically improve the ability of many providers to keep older adults out of the hospital and emergency room.  

Specifically, we applaud CMS for proposing to make additional payments covering complex chronic care management, which comprises non-face-to-face care provided to the most severely ill Medicare beneficiaries. These are beneficiaries who suffer from two or more chronic illnesses and must have a care plan that is continually monitored and revised based on their condition. The proposed payments will allow geriatricians and other healthcare professionals to develop the infrastructure and hire the clinical staff needed to provide high-quality, person-centered care while also helping seriously ill older adults avoid unnecessary or unwanted hospital visits. Importantly, CMS also proposes to reduce the administrative burden of performing these procedures, which will greatly increase their availability to those covered by Medicare.

We also applaud CMS for proposing to make payment to physicians who assess and plan care for those with cognitive impairments. It is imperative that individuals living with these conditions be diagnosed as early as possible to ensure they receive high-quality care and are able to involve family members and caregivers in the care planning process.

Other important CMS proposals for 2017 include recognition for the importance of collaborative care between primary care providers and psychiatrists for those with psychiatric conditions like depression and anxiety, as well as care for people with disorders that limit mobility. In both cases, CMS proposes extra payments that will allow providers to manage conditions more effectively.

“We are delighted that CMS included these services in the 2017 Proposed Physician Fee Schedule. Their inclusion is a key component of better care,” said Nancy E. Lundebjerg, MPA, Chief Executive Officer of the AGS. “In proposing these codes, CMS is recognizing the importance of supporting healthcare professionals who provide high-quality, person-centered care to older adults with complex illness.”

In applauding the CMS for these proposals, the AGS has been joined by a diverse cadre of stakeholders, including the American Academy of Home Care Medicine (AAHCM), American Academy of Hospice and Palliative Medicine (AAHPM), American Academy of Neurology (AAN), and AMDA—The Society for Post-Acute and Long-Term Care Medicine. 

 About the American Geriatrics Society

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit americangeriatrics.org.

About the American Academy of Home Care Medicine 

The American Academy of Home Care Medicine (AAHCM) represents thousands of physicians, nurse practitioners, physician assistants, and related professionals and organizations who care for the sickest, costliest Medicare beneficiaries. These patients are home limited due to multiple chronic illnesses, frailty and disability. Together these medical professionals and organizations strive to improve the medical care of patients in the home.

About the American Academy of Hospice and Palliative Medicine

The American Academy of Hospice and Palliative Medicine (AAHPM) is the professional organization for physicians practicing Hospice and Palliative Medicine. AAHPM’s nearly 5,000 members also include nurses and other health and spiritual care providers who are committed to improving the quality of life of seriously ill patients and their families. For close to 30 years AAHPM has been dedicated to expanding access of patients and families to high-quality palliative care and advancing the discipline of Hospice and Palliative Medicine through professional education and training, development of a specialist workforce, support for clinical practice standards, research, and public policy. Visit www.aahpm.org to learn more.

 About the American Academy of Neurology (AAN)

The American Academy of Neurology (AAN), an association of 30,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

 About AMDA—The Society for Post-Acute and Long-Term Care Medicine

AMDA—The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PA/LTC) settings. The Society’s 5,500 members work in skilled nursing facilities, long-term care and assisted living communities, CCRCs, home care, hospice, PACE programs, and other settings.