By Bruce Chernof, M.D.
Last month marked the one-year anniversary of the Patient Protection and Affordable Care
Act (ACA). Much has happened in the past 12 months to get the new health law up and
running and positive results – especially for America’s seniors – are beginning to show.
Nearly 4 million Medicare beneficiaries are receiving help with prescription drug costs
and over 150,000 have received a free annual wellness visit. As America’s health care
system starts to find a better balance between treatment and wellness, the wheels of
change towards a more person-centered, cost-efficient system will continue to gather
Nowhere is this clearer than in the president’s continued support of the Community
Living Assistance and Supportive Services (CLASS) plan. The Office of CLASS opened
its doors under the leadership of Assistant Secretary Kathy Greenlee and is housed in the
Administration on Aging.
CLASS represents a paradigm shift in how Americans can
plan for their needs as they grow older while helping to decrease reliance on public
programs that are centered on poverty. CLASS is projected to decrease Medicaid costs
by roughly $2 billion at the federal level alone with additional savings to states as well.
CLASS provides an important incremental step to re-imagining the system most of us
will need, promoting independence in a world where we all live longer than we think and
likely face physical challenges.
While implementing CLASS will require modifications
to what is outlined in the law, Secretary Kathleen Sebelius has indicated that she will
exercise the full authority provided to her in the statute to ensure a future of solid
protections for people who will need assistance, while strengthening the financial
viability of the program.
As we look to its launch in 2012, the focus will begin to shift to
raising public awareness about future needs, promoting the benefits of CLASS with
employers, and addressing important questions about premiums and earning thresholds.
Another milestone in this first year of health reform is the establishment of the Federal
Coordinated Health Care Office (CHCO). Americans who qualify for both Medicare and
Medicaid are often among the sickest and most vulnerable users of the health care
system, and these two important programs have never worked well together to address
their needs in a coordinated fashion.
Under the leadership of Melanie Bella, CHCO has
already developed a clear list of existing regulatory barriers that they intend to resolve.
CHCO has also partnered with the Center for Medicare and Medicaid Innovation
(CMMI), making up to $15 million available in planning funds to states in order to jump
start the implementation of new models serving dually eligible individuals.
the broader responsibility of testing and studying the most promising models of payment
and service delivery. Since its launch, the Center has engaged a wide variety of
stakeholders by holding two national Open Door Forum Calls, five in-person listening
sessions in locations throughout the country, five Regional Listening Session Calls, and
participating in the December 2010 Health Affairs convening.
New grants and programs made available through ACA will also help people navigate
health and long-term care programs. In September 2010, the Administration on Aging
and CMS announced $68 million in grants to support community living for seniors and
individuals with disabilities. These funds will help older people and their families
navigate the myriad of options for accessing supports in the community that allow
individuals to remain in their homes. This is particularly critical when older Americans
are seeking to safely transition back to their homes and communities after a hospital or
nursing home stay.
We’ve come a long way, and there is still much to do to transform the way health care
and supportive services are designed and delivered for older people and their families.
The goal is for person-centered and cost-effective care built in a way that services work
together, not operate in their own silos. The sum must be greater than the parts if we are
to have the person-centered system we all want and expect. Ultimately, we don’t have to
grow old alone or in institutions. With a better system, we can spend our later years in
supportive communities and living in the ways we want: healthy, independent and
maintaining a strong sense of identity with age.
Bruce Chernof, MD, is president and CEO of The SCAN Foundation.
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