Medicare Bill Would Reward Elderly for Good Health

Bipartisan bill seeks to strengthen Medicare by keeping seniors healthy

U.S. Senators Ron Wyden, D-Ore., and Rob Portman, R-Ohio, and U.S. Representatives Erik Paulsen, R-Minn., Ron Kind, D-Wisc., Tim Griffin, R-Ark., and Marcia Fudge, D-Ohio, today (Wednesday, June 26) introduced legislation aimed at saving Medicare billions by encouraging seniors to get and stay healthy.

The bipartisan, bicameral legislation would create the Medicare Better Health Rewards program. This entirely voluntary program is designed to help motivate Medicare beneficiaries to get and stay healthy by providing financial incentives for reaching achievable goals set with their physicians. It is the first proposal to offer Medicare enrollees financial rewards for reaching health care goals. The rewards would be paid entirely from savings generated by seniors getting healthy and needing less health care services.

“The Medicare Better Health Rewards program is based on a simple idea – if you help Medicare save money, you share in the savings,” Wyden said. “It’s an innovative approach that can improve care and significantly reduce costs without cutting Medicare benefits. The Medicare guarantee is a godsend and lifeline for millions of older and disabled Americans, and the best way to preserve that guarantee is to squeeze as much value as possible out of every dollar.”

“As the population ages over the next decade, Medicare spending is projected to continue to grow at rates far outpacing inflation. This rate of growth is simply unsustainable, and if not checked, will eventually bankrupt the federal government. It’s critical Washington puts this vital program on a sustainable path by supporting cost-effective solutions that save and strengthen it,” said Portman. “By changing the focus of Medicare from dealing with people when they’re sick to incentivizing seniors to lead healthier lives, our Better Health Rewards bill will reduce Medicare’s soaring costs and save taxpayers’ money since healthier seniors who voluntarily opt-into the program will have fewer doctor and hospital visits and fewer chronic diseases. I’m glad it has the support of well renowned medical organizations such as the Cleveland Clinic and believe the Senate should take it up for bipartisan consideration.”

“The latest estimates by the Medicare trustees confirms the unsustainable path Medicare is on. With an unfunded liability of $43 trillion – or almost three times the size of our economy – we must find innovative new ways to rein in costs and strengthen this important program,” said Paulsen. “This bill will reduce Medicare costs by rewarding seniors who take steps to improve their health. By providing patients with the tools they need to get and stay healthy, we not only help American seniors live longer, healthier lives, but help strengthen a program so many American seniors rely on.”

“This is exactly the kind of bold, concrete and commonsense legislation that we need to rein in health care spending and help our seniors live healthy lives,” said Kind. “This program sets achievable health goals, outlines specific plans to meet those goals, and provides incentives to keep participants motivated and engaged. The end result is a healthier population, lower health care costs and a stronger Medicare program.”

“Medicare is a critically important program that folks like my mom depend on, and failure to save and strengthen it threatens the health and retirement security for all Americans,” Griffin said. “The Better Health Rewards program is an innovative, bottom-up way to encourage seniors to live healthier lifestyles and help preserve this valuable program.”

“Helping our seniors to live a healthier lifestyle is the right prescription for our times,” Fudge said. “The Medicare Better Health Rewards program provides incentives to Medicare beneficiaries to accomplish that goal. It encourages them to take advantage of free wellness visits and medical screenings which can lead to illness prevention and earlier, more cost effective treatment for medical conditions. The reduction of overall health care costs can only strengthen Medicare for today’s seniors and future generations.”

Medicare Better Health Rewards is a three-year wellness program that uses the annual wellness visit Medicare already pays for to ascertain and measure improvements in six key areas of health: tobacco usage; body mass index; diabetes indicators; blood pressure; cholesterol; and, up-to-date vaccinations and screenings. These areas have been identified by experts as leading predictors of future health challenges.

According to the Centers for Medicaid and Medicare Services, more than 3 million seniors took advantage of Medicare’s free annual wellness visit last year.

First-year participants would be assessed in each of these areas and then work with their doctor to develop a plan to bring those indicators into a healthier range. Progress would be measured during subsequent wellness visits in years two and three of the program. Participants who achieve and maintain their indicator targets would be eligible for up to $200 after their second visit and up to $400 after their third visit.

Under the program, the Centers for Medicare and Medicaid Services (CMS) will calculate savings by deducting the actual cost of seniors enrolled in the program from the total projected costs of those participating absent the program.

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