December 06,2018

Wyden Recognizes Bipartisan Health Care Accomplishments, Charts Next Steps on Chronic Care

In Remarks at the Bipartisan Policy Center, Ranking Member Wyden Honors Chairman’s Leadership Role on Chronic Care, CHIP While Signaling Medicare Improvements for the Future

Washington, D.C. – Senate Finance Committee Ranking Member Ron Wyden, D-Ore., today spoke at the Bipartisan Policy Center to honor the leadership of retiring Finance Committee Chairman Orrin Hatch, R-Utah, on the passage of the CHRONIC Care Act, and to offer ideas on additional improvements that could be made to update the Medicare guarantee for seniors now and into the future. The event focused on the CHRONIC Care Act, which passed earlier this year and has entered the implementation phase.

An abridged version of Sen. Wyden’s prepared remarks can be found below. Video of the event can be found here.

Without Chairman Hatch’s commitment to taking on the chronic care challenge, this bill would not have become law. If I had told anybody in this room at the beginning of 2017 that the Finance Committee would lead the way to pass this transformative Medicare legislation, a 10 year extension of CHIP, and the most significant reform of foster care in a generation, you would’ve told me I was hallucinating. But it’s done, and that’s in large part thanks to the work of my friend Orrin.

When I first started looking at updating the Medicare guarantee for seniors with chronic illnesses, it came out of a recognition Republicans and Democrats were missing the big questions. While the focus has been on who gets paid what, Congress has lost sight of how seniors cope with the infinitely complicated health care system as it exists today. Our bill, the CHRONIC Care Act, took on the basic proposition that Medicare does not reflect seniors’ health care needs today. Every senior receives the same Medicare card, but they receive their care in different ways. That was the basis for the bill Chairman Hatch and I authored with Senators Isakson and Warner. Our bill offered innovative approaches for seniors in all of the different ways they get care.

Looking ahead, I want to highlight several additional areas where I believe it’s high time for further action – especially for traditional Medicare.

I believe that it’s imperative that every senior with complex chronic illnesses in Medicare has an advocate working on their behalf to ensure the program is working for them, not against them. Too often in town meetings around Oregon I hear from seniors about the byzantine maze of medical records, doctor visits and other barriers that cause endless stress while older Americans try to navigate the health care system.

In my view, one way to fix this is to empower a person to be the “point guard” who advocates for the senior to ensure all of their care providers are pulling on the same end of the rope. This “point guard,” for example, would coordinate with a beneficiary’s cardiologist and nephrologist to ensure that every provider had up to date records and their treatments plans complemented each other, so seniors get the best possible care. Medicare Advantage and Accountable Care Organizations are ahead of the curve on this – Congress needs to act to make sure seniors with traditional Medicare don’t fall behind.

Another area that needs significant improvement is care for seniors after they leave the hospital. Four in ten Medicare beneficiaries who were living at home prior to a hospitalization and had a subsequent nursing home stay are never able to live independently at home again. Medicare spends $60 billion per year on care received after leaving the hospital. 

However, many of these patients do not receive the quality of treatment they deserve and, in some cases, end up worse off than when they started. Medicare Advantage has had better results, and I want seniors who prefer traditional Medicare to have the same chance as anybody else to go home after a trip to the hospital. Virtually all Americans would prefer to be at home than any type of medical facility, when given the choice.

Finally, updating the Medicare guarantee means improving the experience of patients and their family members during the last months and days of life. All Medicare beneficiaries, including those enrolled in a Medicare Advantage plan, should have seamless access to palliative and hospice services. For example, Congress should remove barriers so that seniors enrolled in Medicare Advantage can have increased access to hospice. Beneficiaries who elect hospice should receive the care they need, expect, and deserve. 

Hospice providers are required to detail a care plan for every beneficiary who elects hospice.  Unfortunately, the HHS Inspector General has raised concerns that many hospice providers are not following through on these plans and providing less care than the patients and families expect.  Nearly 3 out of every 4 hospice patients do not receive a visit from a hospice physician.  And, despite being a 24 hour/7 day a week benefit, the Inspector General found relative few hospice services are provided on weekends. 

If there is anything to take away from my remarks, it’s that traditional Medicare cannot be left behind. Medicare Advantage offers the flexibility for plans to try new ideas to deliver better care for seniors who enroll, but that can’t come at the expense of the more than 60 percent of seniors who count on traditional Medicare or an Accountable Care Organization for their care.

There’s a lot of hard work to do in the weeks and months ahead to put pen to paper and work with everybody in this room as well as my colleagues on the Finance Committee to chart a path forward. The work of any public servant who works on health care should be updating and strengthening the Medicare guarantee so it always provides a modern, robust benefit to seniors, and it will be my work as long as I have the honor of serving as a senator from Oregon and Ranking Member of the Finance Committee.