Implementing the CHRONIC Care Act

The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act was passed and signed on February 9, 2018. The law makes significant policy changes to advance the goals of integrated, person-centered care for Medicare beneficiaries and those dually eligible for Medicare and Medicaid.

The CHRONIC Care Act addresses three aspects of care for Medicare and dually eligible beneficiaries:

  1. Encourages use of flexible tools and strategies to better manage care for individuals with complex needs. The law gives MA plans greater flexibility to cover non-medical benefits for identified high-need, high-risk members, such as bathroom grab bars and wheelchair ramps. Medicare Advantage (MA) plans and accountable care organizations (ACOs) may now offer a broader array of telehealth benefits.

    ->>>[NEW] Our latest resource reviews opportunities for serving complex care populations in MA plans.
  2. Protects and builds on key programs serving individuals with complex care needs. The law permanently authorizes special needs plans (SNPs) whereby managed care organizations can target and serve high-need, high-risk Medicare beneficiaries (i.e., dual eligibles, people with chronic health conditions, people living in institutions). It also extends and expands a demonstration whereby physicians serve very high-need Medicare beneficiaries in their homes to avoid institutional care.
  3. Signals that care coordination and integration are explicit and essential purposes of SNPs. The law requires SNPs to better integrate care by creating unified plans for dual eligible individuals, as well as a single pathway for grievances and appeals.