WELShift In the News - Article Detail

 

The State of Medicare 9/1/2014 Author: Ron Jennette, C.M.A, C.A.S.P. - President and Chief Executive Officer of MRC Healthy Living Communities...

In 1965, Congress created Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older, regardless of income or medical history. Today, Medicare guarantees access to health insurance for Americans age 65 and older, younger people with disabilities, and people with end stage renal disease (ESRD).
 

As of 2010, Medicare provided coverage healthcare coverage to 39.6 million people age 65 and older; 7.9 million people under age 65 with disabilities; and 101,000 people under age 65 with ESRD. That total includes about 3 million Texans who receive Medicare benefits. (statehealthfacts.org)
 

By 2030, Medicare is projected to increase enrollment to more than 80 million recipients, and Medicare spending is projected to increase from $560 billion in 2010 to just over $1 trillion by 2022. In the same year, according to the recently released report by the trustees of Medicare and Social Security, the trust fund for Part A will run dry.
 

It’s up to us to make sure Medicare survives, and thrives, well into the future. In that regard, Congressmen Joe Barton and Ralph Hall signed on as cosponsors of HR 2376, the Medicare Residential Care Coordination Act. And Congressman Gene Green plans to do the same when Congress reconvenes in September 2014. The bill, written by Congressman Michael Fitzpatrick, will provide substantial savings to the government to help maintain the solvency of the program for future generations. The Medicare Residential Care Coordination Demonstration Project (H.R. 2376), will help to sustain the promise of Medicare with a common-sense approach of building on successful and effective reforms that have a widespread following in Texas and around the country.
 

Medical homes, care coordination, accountable care organizations and chronic disease management are among the most promising strategies for lowering costs and improving senior health care delivery. In addition, recent studies, including one in the New England Journal of Medicine , demonstrate that a congregate senior living environment such as in Continuing Care Retirement Communities (CCRC’s) is the ideal setting to integrate these strategies to lower costs and improve outcomes for Medicare seniors because of the near-constant interaction between staff and residents.

 

H.R. 2376 applies these and other strategies to a residential/community setting to maximize their effectiveness. These new communities would lower the total cost of care for seniors by providing on-site care coordination and disease management services to avoid hospitalizations. An interdisciplinary health care team, led by salaried primary care physicians would integrate comprehensive primary and post-acute health care services and coordinate acute and specialist care.

 

H.R. 2376 will allow states like Texas to create and implement new models which offer the health care services of Medicare and Medicaid in a Continuing Care Retirement Community. These new senior communities will feature lifetime health and housing benefits within the existing Medicare and Medicaid programs in a residential environment, specifically a continuing care retirement community. WELShift, http://www.welshift.org, a senior housing and healthcare model that promises substantially improved outcomes for seniors and projected savings of 30% for Medicare and 20%-35% for Medicaid, will be more responsive to seniors’ needs, more accessible to the growing aging population, and a more efficient use of taxpayer resources.
 

As we continue to look for new and innovative ways to ensure Medicare remains fully funded, we look forward to working with industry and legislative leaders like Congressmen Barton, Hall and Green to keep the program healthy with a diet that includes both cost savings and improved outcomes for our seniors.