March 28, 2012

Fixing Medicare by Keeping Seniors Healthy

Wyden, Portman Introduce a Medicare Wellness Program that Experts Predict Could Save Medicare Billions; Helps Move Focus from ‘Sick’ Care to ‘Health’ Care

Washington, D.C. – Recognizing that raising premiums and cutting benefits aren’t the only ways to deal with the growing cost of Medicare, U.S. Senators Ron Wyden (D-Ore.) and Rob Portman (R-Ohio) introduced legislation today that experts say could save Medicare billions by helping seniors get and stay healthy.
The Medicare “Better Health Rewards” program is a 100% voluntary program designed to help Medicare beneficiaries get and stay healthy by giving participating seniors achievable goals, a plan to reach them and incentives to keep motivated.  It is the first proposal to offer financial rewards for reaching health care goals.  Those rewards will be paid entirely by savings generated by seniors getting healthy and using less health care services.  In other words, participating seniors who save Medicare money will be given an opportunity to share in the savings.

“The Better Health Rewards program builds on the notion that the best health care costs the least because it keeps you healthy,” Wyden said. “By focusing on health indicators that contribute to chronic and debilitating health problems -- like  smoking, body mass index, diabetes, blood pressure and cholesterol – and giving seniors the tools they need to make changes and stay motivated, seniors and the entire Medicare program can live healthier, longer lives.  Because the reality is healthier seniors use less health care.”

“With Medicare on a fiscally unsustainable path, Washington should support innovative, cost-effective solutions that save and strengthen it,” said Portman.  “The Better Health Rewards Bill is good policy because it will likely reduce Medicare costs in the long run by rewarding beneficiaries who improve their health. I’m glad it has the support of well renowned medical organizations such as the Cleveland Clinic and hope the Senate will take it up for consideration.”  
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 as leading predictors of future health challenges.

In the first year, Medicare beneficiaries who choose to participate in the program will be assessed in each of these areas and then work with their doctor to develop a plan to bring their indicators into a healthier range.  The senior’s progress will be measured during subsequent wellness visits in years two and three of the program.  At those visits progress will be recognized for achieving and maintaining their targets in each of the key indicators.  As added motivation to stick with the program, seniors earning 20 or more points will be eligible for a “Better Health Reward” paid for by the program’s savings.

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.
Joining Wyden and Portman to introduce the Better Health Rewards program were Drs. Toby Cosgrove and Michael Roizen of the Cleveland Clinic, Dr. Jeanette Mladenovic of OHSU, Mary Grealy of the Healthcare Leadership Council and Dr. Willie Underwood of the University of Buffalo’s Roswell Park Cancer Institute representing the Large Urology Group Practice Association.
“Transforming the delivery of healthcare in this nation from 'sick' care to 'health' care takes commitment. I applaud the efforts of Senators Wyden and Portman to bring this issue to the forefront. We need to reduce the burden of chronic disease in the U.S., which accounts for 40 percent of premature deaths," said Toby M. Cosgrove, M.D., President and Chief Executive Officer at the Cleveland Clinic. "Focusing on healthy behaviors will go a long way toward creating a healthier nation.”

“Slowing the escalation in chronic disease is essential if we are to maintain affordable, accessible healthcare.  We can and must achieve better health among American seniors, many of whom have one or more chronic illnesses,” said Healthcare Leadership Council president Mary R. Grealy. “Advancing wellness and disease prevention requires a combination of private sector innovation and thoughtful legislation such as the Medicare Better Health Rewards Program Act.  We’re making progress, but that progress needs to be accelerated.”

“We sincerely appreciate and strongly support Senator Wyden's bipartisan effort to ensure that Medicare beneficiaries continue to have access to life-saving screening for prostate cancer and other diseases through the proposed ‘Better Health Rewards’ program," stated Dr. Deepak A. Kapoor, president of the Large Urology Group Practice Association and chairman and CEO of Integrated Medical Professionals, PLLC.  "We also appreciate Dr. Underwood's work to illustrate how prostate cancer screening is vital to the health of underserved and minority populations, and how this program can help ensure access to those patients who are at greatest risk from this disease.”

“Promoting creative ways to reduce chronic illness, to encourage physical activity, and to incentivize healthy nutrition, as suggested by the Medicare Better Health Rewards Program Act, makes common sense,” said Dr. Jeanette Mladenovic of OHSU.  “Wellness programs that promote healthy life styles are also an excellent way to keep seniors engaged which we know helps maintain cognitive function.”

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