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The Number: 3%

Submitted by Rob Wyse on Fri, 06/22/2018 - 14:59


Just 3 percent of Medicare beneficiaries represent 25 percent of Medicare expenditures.

According to a Bloomberg BNA report on June 18, even with this sizable share of funds, the three percent, made up of the advanced illness population, isn’t properly cared for by the current health care system. Now a proposal has been made for a new payment model just for this group with the most serious illnesses.

Alternative payment models were presented to HHS Secretary Alex Azar this month, who favored options serving those in various stages of serious illnesses, but ineligible or unwilling to enroll in hospice, according to Bloomberg BNA.

“The idea of these alternative payment models is to get away from Medicare’s strict reimbursement requirements and allow for a flexible payment structure; in this case to support the different types of services needed by very sick patients and their caregivers,” reported Mindy Yochelson for Bloomberg BNA.

No formal government announcement has been made yet, but the initial reaction to the plans have been very promising. “This is the strongest response from HHS yet to a proposal,” the co-chair of Coalition to Transform Advanced Care told Yochelson.