June 26, 2013

Bipartisan Bill Seeks to Strengthen Medicare by Keeping Seniors Healthy

Better Health Rewards Gives Seniors Chance to Share in the Savings

WASHINGTON U.S. Senators Ron Wyden, D-Ore., and Rob Portman, R-Ohio, and U.S. Representatives Erik Paulsen, R-Minn., Ron Kind, D-Wisc., Tim Griffin, R-Ark., and Marcia Fudge, D-Ohio, today introduced legislation aimed at saving Medicare billions by encouraging seniors to get and stay healthy.

The bipartisan, bicameral legislation would create the Medicare Better Health Rewards program. This entirely voluntary program is designed to help motivate Medicare beneficiaries to get and stay healthy by providing financial incentives for reaching achievable goals set with their physicians. It is the first proposal to offer Medicare enrollees financial rewards for reaching health care goals. The rewards would be paid entirely from savings generated by seniors getting healthy and needing less health care services.  

“The Medicare Better Health Rewards program is based on a simple idea – if you help Medicare save money, you share in the savings,” Wyden said. “It’s an innovative approach that can improve care and significantly reduces costs without cutting Medicare benefits. The Medicare guarantee is a godsend and lifeline for millions of older and disabled Americans, and the best way to preserve that guarantee is to squeeze as much value possible out of every dollar.”

“As the population ages over the next decade, Medicare spending is projected to continue to grow at rates far outpacing inflation. This rate of growth is simply unsustainable, and if not checked, will eventually bankrupt the federal government. It’s critical Washington puts this vital program on a sustainable path by supporting cost-effective solutions that save and strengthen it,” said Portman. “By changing the focus of Medicare from dealing with people when they’re sick to incentivizing seniors to lead healthier lives, our Better Health Rewards bill will reduce Medicare’s soaring costs and save taxpayers’ money since healthier seniors who voluntarily opt-into the program will have fewer doctor and hospital visits and fewer chronic diseases. I’m glad it has the support of well renowned medical organizations such as the Cleveland Clinic and believe the Senate should take it up for bipartisan consideration.”  

“The latest estimates by the Medicare trustees confirms the unsustainable path Medicare is on. With an unfunded liability of $43 trillion – or almost three times the size of our economy – we must find innovative new ways to rein in costs and strengthen this important program,” said Paulsen. “This bill will reduce Medicare costs by rewarding seniors who take steps to improve their health. By providing patients with the tools they need to get and stay healthy, we not only help American seniors live longer, healthier lives, but help strengthen a program so many American seniors rely on.” 

“This is exactly the kind of bold, concrete and commonsense legislation that we need to rein in health care spending and help our seniors live healthy lives,” said Kind. “This program sets achievable health goals, outlines specific plans to meet those goals, and provides incentives to keep participants motivated and engaged. The end result is a healthier population, lower health care costs and a stronger Medicare program.”

“Medicare is a critically important program that folks like my mom depend on, and failure to save and strengthen it threatens the health and retirement security for all Americans,” Griffin said.  “The Better Health Rewards program is an innovative, bottom-up way to encourage seniors to live healthier lifestyles and help preserve this valuable program.”

“Helping our seniors to live a healthier lifestyle is the right prescription for our times,” Fudge said. “The Medicare Better Health Rewards program provides incentives to Medicare beneficiaries to accomplish that goal. It encourages them to take advantage of free wellness visits and medical screenings which can lead to illness prevention and earlier, more cost effective treatment for medical conditions. The reduction of overall health care costs can only strengthen Medicare for today’s seniors and future generations.”

Medicare Better Health Rewards is a three-year wellness program that uses the annual wellness visit Medicare already pays for to ascertain and measure improvements in six key areas of health: tobacco usage; body mass index; diabetes indicators; blood pressure; cholesterol; and, up-to-date vaccinations and screenings.  These areas have been identified by experts as leading predictors of future health challenges.

According to the Centers for Medicaid and Medicare Services, more than 3 million seniors took advantage of Medicare’s free annual wellness visit last year.

First-year participants would be assessed in each of these areas and then work with their doctor to develop a plan to bring those indicators into a healthier range. Progress would be measured during subsequent wellness visits in years two and three of the program. Participants who achieve and maintain their indicator targets would be eligible for up to $200 after their second visit and up to $400 after their third visit.

Under the program, the Centers for Medicare and Medicaid Services (CMS) will calculate savings by deducting the actual cost of seniors enrolled in the program from the total projected costs of those participating absent the program.

The effort to establish the Medicare Better Health Rewards program has the support of a number of experts in the medical community including:

President and Chief Executive Officer, Cleveland Clinic, Delos M. Cosgrove, M.D.:

“On behalf of the Cleveland Clinic, I want to thank the members of the House and Senate for introducing the Better Health Rewards Act, legislation that would provide Medicare patients with rewards for improving their health, or maintaining their good health.  Encouraging better lifestyles for Medicare beneficiaries may, ultimately, be the best way to curb costs and improve care.  I look forward to working with the sponsors of this legislation and their colleagues to pass this important bill.”


American Medical Group Association (AMGA):

“American Medical Group Association enthusiastically supports the Better Health Rewards Act.  This legislation will engage patients and incentivize them to take an active role in managing their health.  The bill also will help minimize unnecessary costs by improving the overall health of patient populations and reducing hospitalizations.  We commend the House and Senate sponsors of this legislation for their leadership on this important issue and look forward to working with them.”


President and Chief Executive Officer, Baylor Healthcare System, Joel Allison:

“Baylor Health Care System, headquartered in North Texas, is very pleased to support the Better Health Rewards Act being offered by Senators Wyden and Portman.”
“For Baylor Health Care System, helping beneficiaries adopt healthier lifestyles is a top priority.  We believe in health care, not sick care, and that the best way to improve the health of the country and lower costs for all is to encourage Americans to stay well and avoid the need to use higher cost sites of service.”


The Ohio State University (OSU) Senior Vice President and Chief Executive Officer of the OSU Wexner Medical Center, Steven G. Gabbe, M.D.:

“We heartily endorse this initiative to bring life-changing wellness incentives to our Medicare population. This is a proactive approach to encourage healthy behavior among older Americans. We know that by working with their health care team, these patients can have healthy lifestyles and an improved quality of life as they age.”

“The Ohio State University Wexner Medical Center is committed to our health and wellness programs that benefit our employees’ in many ways that are similar to this proposed legislation. Our wellness efforts encourage employees to receive medical plan premium reductions by getting annual physical exams, appropriate health screenings, and tracking health-related activities including tobacco cessation, weight management and exercise. I applaud Senator Portman for his forward thinking policy that would improve the health of so many.”