August 07, 2009

Senators Chart New Course for Fighting Chronic Disease in Medicare Patients

Back Your Health Act will support cost-saving "lifestyle programs"

WASHINGTON, D.C. - Helping Congress deliver on its pledge to reduce health care costs and improve Americans' health, U.S. Senator Ron Wyden (D-Ore.) introduced the Take Back Your Health Act of 2009 (S. 1640), with cosponsors U.S. Senators John Cornyn (R-Tex.) and Tom Harkin (D-Iowa). The bill creates a new Medicare program based on what are known as "comprehensive lifestyle programs" that have proven to cut the costs of treatment for chronic diseases. The Take Back Your Health Act embraces a pay-for-performance type system, through which doctors are held responsible for their success. Doctors will not receive payment for their work if the patient ends up back in the hospital for his or her chronic illness. They will only get paid if their patient's health status improves.

"This is a groundbreaking bill, based on the proven idea that lifestyle changes can improve the health of those with chronic disease if people stick with a program that has that goal in mind," said Wyden. "The Take Back Your Health Act gets doctors and patients invested in the success of treatment, since doctors won't be paid unless their patients actually get better."

"This legislation will provide seniors who have chronic diseases with the care coordination, training, and support necessary to make and sustain intensive lifestyle changes that have been clinically proven to beneficially affect or even reverse the progression of many chronic diseases," said Cornyn. "I'm pleased to join with my colleagues in a bipartisan fashion and will continue pushing for common-sense solutions to our health care system."

"The health reform debate is not about continuing the status quo, but about changing our health care system and the medicine we do," Senator Harkin said. "This legislation will change the medicine Medicare does by reimbursing health care professionals for proven programs to address disease, including coronary heart disease, diabetes, and some forms of cancer, through intensive lifestyle change. Health reform is about giving individuals more choices and individuals should be given the option to engage in a lifestyle treatment program instead of surgery and pills."

The Take Back Your Health Act was crafted after consultations with some of America's leading experts in the health benefits of prevention. Their advice led to the development of the concept for comprehensive lifestyle treatment programs in the bill, which are treatment plans that doctors write and design specifically for each patient as a framework for improving his or her health. Programs may only qualify for funding if they can demonstrate that they cut costs or at least yield revenue neutral results and that they have led to improvements in a patient's medical condition that can be measured by specific tests. The program may include nutritional therapy, exercise, medication management, care coordination, and tobacco cessation. Several trials, including Mutual of Omaha and Highmark Blue Cross Blue Shield, showed that comprehensive lifestyle programs result in up to 50 percent reductions in medical costs.

The Take Back Your Health Act of 2009 offers funding for programs that treat Medicare patients who have been diagnosed with coronary heart disease, type 2 diabetes, metabolic syndrome, prostate cancer, and/or breast cancer. These chronic diseases account for approximately 75 percent of the $2.1 trillion in America's annual health care costs.