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The Medicare Advantage Experience

December 13, 2012   |   Alliance for Aging Research Team   |   Medicare
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ATLANTA- The most effective way to slow Medicare spending is to reduce the cases of preventable chronic conditions and incorporate evidence-based care coordination into the traditional Medicare program.

Kenneth E. Thorpe, PhD, professor of Health Policy and Management at Emory’s Rollins School of Public Health along with colleague Daniel Perry, president and CEO of the Alliance for Aging Research, suggest adopting specific initiatives such as transitional and team-based care, comprehensive medication therapy management, and health coaching to slow the growth in spending and improve quality of care. The team will host a teleconference on Thursday, December 13 from 10:30 a.m. – 11 a.m. to discuss these recommendations.

Most spending in the Medicare program is for treatment of chronically ill patients. The high prevalence of chronic disease, such as diabetes, is a key contributor to the growth of Medicare costs.

“Since Medicare and Medicaid account for nearly 40 percent of the projected rise in federal costs over the next decade, slowing the growth in federal health care spending is imperative for reducing the federal budget deficit,” says Thorpe, who also serves as co-chair of the Partnership for the Future of Medicare. “Intentional changes in the Medicare program are necessary and the reform discussion must include ways to incorporate modernized healthcare delivery.”

Despite the primary role of chronic diseases in Medicare spending, the program does not provide care coordination or cover lifestyle-related preventive benefits for most patients. The paper discusses the integration of a team-based healthcare model as the best way to improve patient care and health outcomes.

“There is a major need for policy proposals specifically designed to manage and engage chronically ill patients, especially seniors, and reduce clinically unnecessary use of health care services,” says Perry. “Real care coordination will require broader teams of providers such as nurse practitioners, nurses, pharmacists, social workers and others.”

Thorpe and Perry highlight data and evidence that draws from portions of successful plans such as the Medicare Advantage plans and other on-going prevention and care coordination programs. They suggest drawing from these examples as proven best-practice strategies for possible integration into traditional Medicare.

Media interested in attending may phone in at 877-347-0176 / Dial 353734#

The full paper will be available here on Thursday, December 13th at 10:30 a.m. (EST): The_Medicare_Advantage_Experience (PDF Format)

It will also be available at:
Rollins School of Public Health at Emory,
Partnership for the Future of Medicare,

Melva Robertson, 404-727-5692 [email protected]
William Pierce, 202-659-7931 [email protected]
Debbie Zeldow, 202-557-0449 [email protected]

This posting was written by Michael Maroni, public policy assistant at the Alliance.

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