You Should Know...
An Unanticipated Consequence of the CHRONIC Act
The next major statutory change to Medicare Advantage has passed the Senate. The Creating High-volume Results and Outcomes necessary to Improve Chronic care (or CHRONIC) Act (S.870), would, among other things, allow MAOs to include a "tele-health" benefit in their contract proposals.
But there is also a little discussed provision that will have a HUGE impact on Medicare Advantage enrollment---one which changes the manner in which primary care physicians (PCPs) are assigned to traditional beneficiaries under the ACO program.
Currently, assignment of PCPs is based on selection by the patient themselves. With the new provision in the CHRONIC Act, PCPs can be selected for the patient by the ACO itself---and changed at any time.
ACOs are failing badly, and organizations have made enormous investments in time and treasure to get them up and running. This provision is a "hail Mary" attempt to save the program by allowing organizations to shift patients to those primes who work most efficiently within the system.
Now imagine you're a Medicare patient seeking medical care. You're enrolled in an ACO under your PCP, even though you have little understanding and even less interest in what an ACO actually is. Now imagine if that same ACO has the power to reassign you to a different PCP, one of their choosing, with little notice and what will certainly be inadequate notification.
How would you feel?
Then a friend tells you about a different Medicare program---Medicare Advantage. One where you can pick your PCP and only you can change it. How much more likely are you to consider that new program?
If implemented and if this provision survives the certain backlash from beneficiary community, it will be the most effective sales tool for Medicare Advantage that ever existed.
We'll be following this closely as the bill makes it way through the House. It has to potential to shift the entire beneficiary population to majority Medicare Advantage.