High-Need, High-Cost Patients

State of Play: The Department of Health and Human Services (HHS) has released an action plan to reduce maternal deaths and disparities. The U.S. Surgeon General has also released a complementary call to action to improve maternal health.  HHS is working with the American Society of Nephrology and the National Kidney Foundation to create an education, awareness, and prevention campaign about kidney disease. The Centers for Medicare and Medicaid Services (CMS) seasonal flu education campaign is underway, encouraging beneficiaries to get a flu shot. CMS has taken steps to ensure all Americans have access to the COVID-19 vaccine at no cost. CMS has released preliminary data showing that rates of vaccinations, primary, and preventive services among children in Medicaid and the Children’s Health Insurance Program (CHIP) have steeply declined during the COVID-19 public health emergency. CDC has awarded $7 million for a pilot project to reduce chronic disease by advancing health equity. CMS has issued a final rule implementing the End-Stage Renal Disease Treatment Choices Model.

HLC Position: HLC supports chronic disease prevention and management, which affects the Medicare population at disproportionate levels, as essential components of healthcare delivery through better public and private sector development of evidence-based wellness practices. As various value assessments intended to determine whether new and innovative treatments warrant coverage, HLC believes any new structure should include population health and the long-term benefits of health innovations over short-term financial costs, to ensure that these innovations do not serve as unwarranted barriers to patient access. Lessons learned from new approaches within Medicare can help lead to more effective ways of preventing chronic disease. HLC also believes it is important to address social determinants of health (SDOH) and provide greater support for the transportation, nutrition, and other nonmedical needs that can promote patient health and reduce the need for repeat hospitalization. Our initial work has illuminated the need for standardized data collection to better identify individuals in need and the social determinants most affecting patients’ health and well-being.

HLC Recent Activity:

  • In January, HLC released an SDOH report that outlines actionable recommendations to lawmakers, policymakers, and others at the federal, state, and local levels.
  • On January 7, HLC endorsed the “Leveraging Integrated Networks in Communities to Address Social Needs Act.”
  • On December 12, HLC issued a press release on the Food and Drug Administration’s (FDA) emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine.
  • On December 11, HLC joined the COVID-19 Vaccine Education and Equity Project. The project focuses on increasing confidence in the COVID-19 vaccine.
  • On November 30, HLC shared it’s updated COVID-19 legislative priorities list with Senate leadership.
  • In November, HLC joined a letter to President-Elect Biden urging a reprioritization of the Office of National Drug Control Policy to reduce drug use and its consequences.
  • On October 22, HLC presented the Redefining American Healthcare (RAH) award to the Partners in Care Foundation for its efforts to develop high-value models of community-based care and self-management for diverse populations with chronic conditions.
  • On October 7, HLC hosted a second roundtable with Aetna and Tivity Health on addressing SDOH in the private and public sector. HLC will release a report outlining actionable recommendations to lawmakers, policymakers, and key influencers at the federal, state, and local levels.
  • On October 2, HLC responded to the Department of Health and Human Services (HHS) Federal Coordination to Promote Economic Mobility request for information (RFI).
  • On October 2, HLC joined a letter to the National Governors Association on COVID-19’s impact on people with rare, serious, and chronic disease.
  • On September 16, HLC released a blog post on enhancing and expanding access to vaccines.
  • On August 28, HLC joined the “Addressing Diversity in Rare Kidney Disease” workgroup and participated in discussions about rare kidney disease policy and innovation.
  • In August, HLC joined the National Foundation for Infectious Diseases “Keep Up The Rates,” a national campaign to encourage all individuals to get recommended vaccines that may have been delayed during the pandemic.
  • As progress continues on developing COVID-19 vaccines and therapeutics, HLC provided the Department of Health and Human Services (HHS) input on how to encourage the public to enroll in clinical trials and to accept a vaccine once it becomes available.
  • On August 27, HLC participated in the HHS health equity call on COVID-19 vaccine development and a campaign preparing communities for a vaccine.
  • On August 12, HLC wrote Senators Jacky Rosen (D/NV) and Marco Rubio (R/FL) in support of S. 3595, the “Ensuring Understanding of COVID-19 to Protect Public Health Act.”
  • On July 21, HLC joined the National Academy of Medicine’s Opioid Collaborative for a virtual town hall meeting on health equity.
  • On July 21, HLC wrote the Senate Special Committee on Aging in advance of its hearing, “The COVID-19 Pandemic and Seniors: A Look at Racial Health Disparities.”
  • On July 2, HLC joined a letter to the National Clinical Care Commission on reducing health disparities and achieving health equity in diabetes and prediabetes care.
  • On June 23, HLC wrote the Senate Health, Education, Labor, and Pensions (HELP) Committee in advance of its hearing, “COVID-19: Lessons Learned to Prepare for the Next Pandemic.”
  • On June 17, HLC wrote the House Energy and Commerce (E&C) Committee in advance of its hearing, “Health Care Inequality: Confronting Racial and Ethnic Disparities in COVID-19 and the Health Care System.”
  • On June 10, HLC wrote the House Ways and Means (W&M) Committee in advance of its hearing, “Disproportionate Impact of COVID-19 on Communities of Color.”
  • On June 9, HLC posted a blog highlighting an op-ed on the importance of nonessential care patients returning to their doctors to receive care.
  • On April 17, HLC shared its COVID-19 key legislative priorities list with Senate and House leadership for consideration in future legislative packages to address the COVID-19 pandemic.
  • On April 15, HLC released a blog post addressing health inequities related to the COVID-19 pandemic.
  • On April 12, HLC submitted comments to CMS on improving health care access, quality, and outcomes for women and infants in rural communities before, during, and after pregnancy.
  • On March 30, HLC submitted examples of what HLC members are doing to address COVID-19 in the Rural Aging Advisory Council’s (RAAC) newsletter.
  • On March 20, HLC joined a letter requesting the Federal Communications Commission (FCC) to adapt the Lifeline program to address the COVID-19 crisis.
  • HLC postponed a follow-up roundtable with Aetna and Tivity Health on addressing SDOH due to the COVID-19 pandemic.
  • On March 4, HLC attended the Administration for Community Living’s 2020 National Summit on Health Care and Social Service Integration and provided input on the agenda on a preparation call.
  • As members of the RAAC, HLC wrote the Senate Health, Education, Labor, and Pensions (HELP) Committee and the House Education and Labor Committee expressing support for the reauthorization of the Older Americans Act.
  • On February 13, HLC wrote the Senate Special Committee on Aging in advance of its hearing on “There’s No Place Like Home: Home Health Care in Rural America.”
  • On February 3, HLC submitted comments to the Department of Health and Human Services (HHS) National Clinical Care Commission on policies, effectiveness, limitations, and gaps related to prevention and treatment of diabetes and its complications.
  • HLC continues participation in organizations that support issues affecting high-need, high-cost patients, including the Diabetes Advocacy Alliance (DAA), the Obesity Care Advocacy Network (OCAN), the Partnership to Fight Chronic Disease, and RAAC.
  • On January 8, HLC wrote the House Energy and Commerce (E&C) Committee in support of H.R. 3935, the “Protecting Patients Transportation to Care Act.”