Medicare Compliance & Reimbursement

Ten applicants wanted for 3-year pilot.

The Centers for Medicare & Medicaid Services is seeking proposals from organizations interested in coordinating care for Medicare fee-for-service beneficiaries with multiple chronic conditions, Department of Health and Human Services Secretary Tommy Thompson announced April 20.
 
"Too often, seniors with serious health problems move from doctor to doctor for their specific health problems without any single doctor getting a full picture of their needs," Thompson said.

CMS will ultimately select about 10 applicants to participate in the three-year pilot stage of the Voluntary Chronic Care Improvement Program. Each successful applicant will serve 15,000 to 30,000 beneficiaries in a distinct region, and the regions combined must include at least 10 percent of FFS beneficiaries, according to a solicitation for proposals scheduled for publication in the April 23 Federal Register.

The VCCIP pilot, or "Phase I," will focus on congestive heart failure, complex diabetes, and chronic obstructive pulmonary disease. In Phase II of the program, CMS plans to expand successful elements of the pilot to other chronic conditions and to additional regions, possibly nationwide.

Under the unique terms of last year's Medicare Modernization Act, which established the VCCIP at the particular urging of Rep. Nancy Johnson (R-CT), the agency can do this -- indeed, is directed to do this -- without further congressional action. Thus, the VCCIP is protected from the fate of the many Medicare demonstrations that have worked well over the years but died nevertheless when Congress failed to extend them.

To qualify for Phase I, organizations "must have demonstrated success in population-based chronic care improvement services," a CMS statement says.

According to a solicitation for proposals scheduled for publication in the April 23 Federal Register, eligible applicants include, but are not limited to, disease management organizations, health insurers, integrated delivery systems and physician group practices.