High-Need, High-Cost Patients

State of Play:   The Centers for Disease Control and Prevention (CDC) has found death rates are 12 times higher for patients with chronic illness who become infected with COVID-19. COVID-19 has exposed flaws of a reactive health system designed to care for people who are already sick. CDC has begun working with four states and one city on COVID-19 vaccine distribution when it becomes available. Those plans will be shared with other states to use in planning. The National Academies of Sciences, Engineering, and Medicine has formed a committee that will produce a consensus study to assist policymakers in the U.S. and global health communities in planning for equitable allocation of vaccines against COVID-19.

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 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:

  • 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.”