GACCC Act, Geriatric Academic Career Awards, Physician Quality Reporting Initiative, Bush Admin Rejects Citizen`s Group Recommend

Congress Considers Legislation Authorizing Medicare to Cover Geriatric Assessments and Care Coordination

The Senate and House are mulling legislation that would fill a major gap in traditional “fee-for-service” Medicare by authorizing coverage of geriatric assessments and care coordination for beneficiaries with multiple chronic conditions.

Lawmakers in both houses introduced the legislation, the Geriatric Assessment and Chronic Care Coordination (GACCC) Act, on May 9—the same day the Senate convened a hearing to examine the need for care coordination for beneficiaries with multiple chronic illnesses.

The American Geriatrics Society (AGS) worked 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. AGS President Todd P. Semla, PharmD, provided key testimony (available at https://www.americangeriatrics.org) during the May 9 hearing before the Senate Special Committee on Aging.

“Currently, about 20% of Medicare beneficiaries have five or more chronic conditions, and these individuals account for almost 70% of all Medicare spending,” Dr. Semla told legislators, noting that treatment of patients with multiple health problems is highly complex.

“Studies show that care coordination raises the quality of care, improves health outcomes and reduces healthcare costs for individuals with chronic conditions,” he reported. “This means fewer hospital visits are needed, duplicative services or 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.”

As of mid May, 30 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, had endorsed the GACCC Act.

Applications for 2007 Title VII Geriatrics Academic Career Awards (GACAs) Now Available

Applications for 2007 federal funds for Title VII Geriatrics Academic Career Awards (GACAs) are now available on the federal Health Resources and Services Administration (HRSA) website at www.hrsa.gov. Applications are due June 18. Applications for Title VII funds for Geriatric Education Centers (due May 14) and for geriatric training for physicians, dentists, and behavioral and mental health professionals (due June 6) were also available.

A year after Congress voted to eliminate 2006 funds for Title VII Geriatrics Health Professions Programs, it restored funding for these crucial programs for 2007. Congress approved the restoration of funding following concerted advocacy efforts by the American Geriatrics Society (AGS), the Association of Directors of Geriatric Academic Programs (ADGAP), and others. Visit www.healthinaging.org/advocacy to participate in current advocacy campaigns.

CMS Announces Measure Specifications for the 2007 Physician Quality Reporting Initiative

The Centers for Medicare & Medicaid Services (CMS) has released complete specifications for the 74 quality measures that will be used in the 2007 Physician Quality Reporting Initiative (PQRI), which begins July 1.

Under the voluntary initiative, eligible healthcare professionals who report data for the measures may qualify for a bonus. The bonus, subject to a cap, may equal up to 1.5% of total allowed charges for services that are provided between July 1 and December 31 and are covered under the Medicare Physician Fee Schedule. The quality measures are evidence- and consensus-based measures that relate to aspects of care that have been linked to improved patient outcomes.

Eligible professionals interested in participating in the PQRI do not need to register. They should simply select the measures that they want to report, then submit the specified quality-data codes on claims for services provided between July 1 and December 31.

CMS recently hosted a series of national conference calls on the PQRI. Written transcripts and Power Point presentations from the most recent call are available at www.cms.hhs.gov/pqri. A call addressing geriatrics care providers is being planned as this article goes to press; details will be provided via AGS Week in Review and the AGS website.

Bush Administration Rejects Recommendations from Citizens' Health Care Working Group

The Bush Administration rejected the Citizens' Health Care Working Group's recommendations for revamping the nation's healthcare system earlier this spring. The group, which was established under 2003 Medicare law to promote "a nationwide public debate" on healthcare, issued the recommendations in a report to the President and Congress. The recommendations were based on healthcare research and a series of nationwide public meetings with more than 6500 Americans over the past year.

Among other things, the group’s report recommended that all U.S. residents have access to affordable, basic health benefits by 2012, and that residents have the opportunity to play a role in revising the nation’s healthcare system. The group—made up of hospital administrators, physicians, nurses, a union president, and a corporate benefits manager—also recommended that an independent, nonpartisan committee be established to develop a list of basic health benefits. The report, however, did not address how the government should fund these benefits.

While the President supported the group’s goals, he didn’t agree with its approach, which was “based on mandates and government intervention,” but, rather, supported “an approach emphasizing consumer choice and options,” Health and Human Services Secretary Mike Leavitt told reporters.