July 1, 2016 | The Road to VBC: Two Major Events for Medicare Patients & Doctors

The third week of June was an important time for individuals closely following Medicare and its various programs. Two potentially landmark changes were announced that could significantly impact those who provide and receive care under the CMS’ banner.

The first was the news that the Senate Appropriations Committee has voted to eliminate the State Health Insurance Assistance Program (SHIP) as part of overall efforts to direct funds towards other federal initiatives. If passed through the full Senate later this summer, the elimination of SHIP would be a major blow for Medicare patients looking to better understand their care options and eligibility.

Since 1990, SHIP counselors have proved a valuable resource to patients across the U.S., giving advice on how to choose from an array of drug and health insurance plans, challenge coverage denials, and receive financial subsidies for premiums, co-payments, and deductibles. SHIP also helps Medicare patients with one-on-one counseling and hosts events for new beneficiaries, in addition to providing a toll-free telephone help-line.

For many Medicare patients, SHIP is a go-to and essential resource–with some states reporting savings as high as $28 million per year.

While SHIP will be disbanded in an effort to uncover funds, the Department of Health and Human Services (HHS) pledged $20 million last week to help support MACRA training and education for Medicare clinicians in individual or small group practices of 15 clinicians or fewer.

The announcement comes on the heels of a report from Blackbook Research showing that many small practices are significantly worried about MACRA changes, and that some believe it could cause them to go out of business altogether. Specifically, the HHS funding will be used to train this exact group, especially those operating in rural areas where they may be short on the staff and resources needed to comply with reporting requirements.

As providers of a crucial service to Medicare beneficiaries and their physicians, we understand how difficult it can be to navigate the intricacies of the different programs. Our own Wellbox Call Center seeks to remedy this by signing up patients for eligible benefits as part of Chronic Care Management, as well as allowing practices to demonstrate value and receive increased reimbursements key to financial success.

With over 10,000 baby boomers joining the Medicare population daily, programs like SHIP and CCM have never been more important. As healthcare progresses further down the road to value-based care, there must be equal attention paid to the assistance we give to our at-risk patients and their clinical caregivers– an endeavor that Wellbox supports in our efforts each day.


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