Schumer, Gillibrand, McHugh to Feds: Choose Adirondack Region for New Medicare Demonstration Project; Would Provide Additional Medical Resources to High Need Region
Adirondack Region Fits All Criteria To Be Chosen for Demonstration Project To Provide Affordable, Accessible Medical Care To High Need Patients
Today, U.S. Senators Charles Schumer, Kirsten E. Gillibrand and Congressman John M. McHugh urged, in a personal letter, the Department of Health and Human Services (HHS) Secretary Kathleen Sebelius to select New York State's Adirondack Region as one of the locations for a federally funded health care pilot program. The program would provide targeted, accessible, continuous and coordinated care to Medicare beneficiaries who have illnesses that require regular monitoring and treatment. The lawmakers noted that the Adirondack Medical Home Demonstration Project is a clear indication of the region's and state's commitment to innovative medical facilities, and their success in implementing effective medical solutions in a region struggling with high unemployment, a lack of insurance and inadequate infrastructure.
The federal pilot program would follow the medical home model, which seeks to coordinate health care services by positioning primary care physicians to serve as coordinators of care. Primary care physicians take responsibility for providing for all the patient's health care needs or taking responsibility for appropriately arranging care with other qualified professionals. In this way, care is coordinated and/or integrated across all elements of the health care system. The Adirondack Medical Home Demonstration Project also follows this model. The federal pilot program would fit hand in hand with the AMHDP, and would allow for the inclusion of Medicare patients in the already existing program.
"Selecting New York State and the Adirondacks for the federal demonstration project makes sense for the federal government and the region and will provide more affordable and easier-to-access healthcare for the region's residents," said Senator Schumer. "The region would benefit from increased access to medical care and the government would learn from the innovative solutions being implemented in a location that is medically underserved."
"The Adirondack Region is the perfect choice for the Medical Home Demonstration Project," said Senator Gillibrand. "Choosing the Adirondacks will help the innovative health care providers in the North Country to continue to provide top-notch care to New Yorkers, while also serving as an example for the rest of the country. I will work with Senator Schumer and Congressman McHugh to make this a reality."
"Ensuring that the residents of New York's 23rd Congressional District have affordable and accessible health care is a top priority of mine. The Adirondack Medical Home Demonstration Project is an innovative solution that has the potential to help meet some of the significant health care challenges in the region," said Rep. McHugh. "Complimenting this existing project with a federal Medicare designation will benefit both our region and, through lessons learned, people throughout the nation. It my hope that the Secretary will take advantage of this unique opportunity to build upon the Adirondack Medical Home Demonstration Project."
"The Medical Home demonstration project currently underway in the Adirondacks may be the only hope to continue the availability of Primary Care in our community. The only piece missing is Medicare participation , which will be critical due to the major role they play as payers on the rural scene. If our community in the Adirondacks is chosen to be included in the Medicare demonstration for the Medical Home, it will yield the most complete picture and gives us the best evidence of whether the Medical Home concept can work, and particularly address whether it can work in a rural setting," said Chandler Ralph, President/CEO of Adirondack Medical Center.
"The medical home model can improve quality of care and hold down costs at the same time," said John Rugge, M.D. CEO of Hudson Headwaters Health Network. "We have to invest in ways to keep people healthy before they require hospitalization and high-end rescue care, and we have to improve coordination of care for those with chronic diseases. The medical home is the right place to start."
"Like many rural communities across the country, the Adirondack region has struggled to attract and retain physicians. The medical home model would better support the physicians of our community, and thereby localize high-quality, sophisticated care for the residents of the Adirondack region, while also substantially improving their health and healthcare," said Stephens Mundy, President and Chief Executive Officer of Champlain Valley Physicians Hospital Medical Center. "The entire Adirondack region is grateful for the leadership shown by Senators Schumer and Gillibrand, and Rep. McHugh, and their efforts to support healthcare in this area."
As part of the Tax Relief and Health Care Act of 2006, HHS will conduct a Medicare Medical Home Demonstration Project beginning in 2010. Up to eight states will be included in the demonstration and HHS is currently determining the designated participating regions. The Act mandates a demonstration to provide targeted, accessible, continuous and coordinated family-centered care to Medicare beneficiaries who are deemed to be high need.
The Adirondack Region faces numerous healthcare challenges. It has a large elderly population, with 17% of its population over the age of 65 compared, to the statewide average of 12.5%. One in five of this population is dually eligible for Medicaid. Subsequently, the region suffers from high morbidity rates for conditions such as congestive heart failure, diabetes, COPD and cardiovascular disease. The rural frontier makeup of these small mountain communities necessitates an integrated, coordinated approach to health care. The region is also largely defined as rural, with many communities characterized by high levels of poverty, seasonal unemployment and lack of health insurance. Most of the area has the federal designations of Medically Underserved Area (MUA) and Health Professional Shortage Area (HPSA).
The Adirondack Medical Home Demonstration Project makes the region a natural choice for the federal pilot program. The participants in the regional, multi-payer project include leading private insurers, who have agreed to transfer care coordination activities from the insurers to primary care providers. These participants, who have also agreed to provide enhances reimbursement, notably include the State of New York through its role as payer for the Medicaid, Child Health Plus, and civil service employee programs. This type of innovative solution in a region that faces tremendous hurdles in providing medical care makes the Adirondacks the perfect location for the federal demonstration project.
A full copy of the letter is below:
April 30, 2009
The Honorable Kathleen Sebelius
SecretaryU.S. Department of Health and Human Services
200 Independence Avenue, S.W. Washington, D.C. 20201
Dear Secretary Sebelius:
Congratulations upon your recent confirmation as Secretary of the U.S. Department of Health and Human Services (HHS). We look forward to working with you and wish you well.
We understand that your office is presently working, pursuant to the Tax Relief and Healthcare Act of 2006 (P.L. 109-432), to designate eight states or regions as demonstration sites for the Medicare Medical Home Demonstration Project. We are writing to ensure you are aware of an opportunity your Department has to construct an all-payer and all-provider Medicare Medical Home Demonstration Project in 2010 upon the foundation of New York's Adirondack Medical Home Demonstration Project.
The Adirondack Medical Home Demonstration Project was initiated in January of 2009. The participants in this regional, multi-payer project include leading private insurers, who have agreed to transfer care coordination activities from the insurers to primary care providers. These participants, who have also agreed to provide enhanced reimbursement, notably include the State of New York through its role as payer for the Medicaid, Child Health Plus, and civil service employee programs. Additionally, the State of New York has recently provided $4.5 million for this Project, which solidly underscores the State's commitment. Thus, with the addition of Medicare, we would truly have an all-payer demonstration project.
We are excited about the Adirondack Medical Home Demonstration Project because it will enhance access to health care for our constituents, who live in New York State's Adirondack Park Region. As you may know, that sparsely populated section of New York State encompasses over six million acres and faces challenges that include inadequate infrastructure, a struggling economy, high levels of poverty, seasonal unemployment, and a lack of health insurance.
Given the fact that 17 percent of the 130,000 residents of this area are older than 65 and that the Adirondack Medical Home Demonstration Project is currently operational, the Adirondack Region would serve as an ideal site for the Medicare Medical Home Demonstration Project. Put simply, if your Department, the State of New York, and other stakeholders can overcome these challenges and adverse circumstances - and we firmly believe they can - the lessons learned can be replicated to enhance health care systems throughout our nation.
Accordingly, we respectfully request that you carefully consider designating New York State's Adirondack Park Region as a Medicare Medical Home Demonstration Site. Thank you for your consideration and please let us know if we can answer any questions or provide any additional information.
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