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Medicare News
Medicare Seeks Ways to Get Senior Citizens to Take
Better Care of Their Health
Awards contracts for Senior Risk Reduction
Demonstration as part of Focus on Prevention
Dec. 19, 2007 Medicare took a big step forward in
its Senior Risk Reduction Demonstration, by awarding contracts to help
find ways to use disease prevention and health programs now used by the
private sector to encourage senior citizens covered by Medicare to do a
better job of managing their health.
The Centers for Medicare & Medicaid Services (CMS)
announced the contracts yesterday.
The news released said, "Taking a comprehensive
approach to health promotion and wellness has been shown to be cost
effective in corporate settings, and the demonstration will try to learn
if it works as well for the Medicare population."
The demonstration, which seeks ways to promote
health and wellness for seniors, will determine if these programs
currently offered by private insurers and employers can be delivered by
Medicare to encourage beneficiaries to engage in healthy lifestyles and
practices that can help them maintain and improve their health, and
reduce the need for health care services for preventable illnesses,
injuries, or complications.
We want to find ways to help Medicare
beneficiaries identify their health risks, including risk factors for
diseases they might not know they have, and provide them with
information and support they need to proactively take better care of
their health, said CMS Acting Administrator Kerry Weems. The
demonstration will address multiple health risk factors that contribute
to chronic diseases, including physical inactivity, obesity, smoking,
depression, high blood pressure, high cholesterol, and high blood sugar,
as well as under-use of Medicares preventive benefits.
Unlike CMSs disease management demonstrations,
which have focused on helping severely chronically ill people to manage
their diseases, this demonstration aims to focus on the other end of the
health and illness spectrum, helping people who are reasonably well
manage their health so they can delay the onset or exacerbations of
chronic disease.
CMS will randomly select beneficiaries under the
age of 75 who may or may not have chronic diseases to invite to
participate in this demonstration.
The five organizations selected through a
competitive process are
● Health Dialog Services Corporation,
● Focused Health Solutions,
● Health Partners Health Behavior Group,
● Pfizer Health Solutions Inc., and
● StayWell Health Management.
These organizations will provide health risk
assessments followed by tailored feedback reports to help participants
identify their health risks and inform them of ways they can improve
their health. Participants will also receive health education and
behavior change materials, and health coaching, provided on an ongoing
basis using their preferred communication method, either through the
mail, telephone, or internet.
Participants will also have the option of having
information shared directly with their physicians.
In addition, participants will receive referrals to
national and local programs, such as physical activity, falls
prevention, smoking cessation, and other types of health promotion
programs, or if needed, referrals to their physician for recommended
clinical preventive services.
We all know that we should engage in healthy
behaviors, like being physically active, eating a nutritious diet, and
not smoking, Weems said.
Sometimes we need information and support to help
us do the right things. The Medicare Senior Risk Reduction
Demonstration will provide tailored information and support to
beneficiaries, helping them to take better care of themselves so they
can maintain their health and independence.
Approximately 85,000 fee-for-service Medicare
beneficiaries randomly selected from across the country will be invited
to participate in the three-year demonstration, 17,000 per demonstration
organization.
The demonstration is unique in that it will also
provide the Department of Health and Human Services the opportunity to
examine the ability of its Aging and Disability Resource Centers,
co-administered by CMS and the Administration on Aging, to link
beneficiaries to health promotion programs in their communities.
While the Aging and Disability Resource Center
grant program was originally initiated to support states in developing a
one-stop shop to help consumers make decisions regarding long term care
options in their communities, they have expanded their role to include
providing information and assistance on other issues, including Medicare
Part D.
The five demonstration organizations will work with
10 Aging and Disability Resource Centers across the country to link
beneficiaries to health promotion programs in their communities.
A one-year pilot to ensure that all processes are
fully operational will begin in April 2008, with the demonstration
beginning recruitment in October 2008.Information on the Medicare Senior
Risk Reduction Demonstration can be found online by
clicking here.
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