FOR IMMEDIATE RELEASE, Contact: (202) 225-3943
April 22, 1997
No. HL-12
Congressman Bill Thomas (R-CA), Chairman, Subcommittee on Health of the Committee on Ways and Means, today announced that the Subcommittee will hold a hearing on coordinated care for beneficiaries eligible for coverage under both the Medicare and Medicaid programs. The hearing will take place on Tuesday, April 29, 1997, in room B-318 Rayburn House Office Building, beginning at 9:30 a.m.
In view of the limited time available to hear witnesses, oral testimony at this hearing will be from invited witnesses only. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing.
BACKGROUND:
As many as six million Americans, known as "dual eligibles," are enrolled in both the Medicare and Medicaid programs, and an additional three to four million Americans are eligible for both programs. For these dual eligibles, Medicaid may help pay Medicare premiums and deductibles, or cover services Medicare does not provide, such as hearing aids, prescription drugs, and long-term nursing home stays.
Most dual eligibles are poor and many have chronic illnesses or complex acute illnesses and are in need of long-term care services. Dual eligibles comprised about 16 percent of the Medicare population but accounted for about 30 percent of total Medicare expenditures in 1995. Similarly, dual eligibles made up 17 percent of the Medicaid population and accounted for approximately 35 percent of Medicaid payments in the same year. Because the fragmentation in today's health system is exacerbated when people are covered by both the Medicare and Medicaid programs, many believe that better coordination of care for dual eligible individuals can save tax dollars while improving the quality of care for this population.
Currently, there is not a generally available comprehensive integrated care benefit available to people eligible for both Medicare and Medicaid. However, there have been two major demonstration projects that have attempted to better coordinate care for some dual eligibles: Programs of All Inclusive Care for the Elderly (PACE) and Social Health Maintenance Organizations (SHMO). The PACE and SHMO programs, which currently cover about 23,000 elderly people, combine Medicare, Medicaid and private funds to provide integrated acute and chronic care services to target populations. In addition, several States, including California, Florida, Massachusetts, Ohio, Wisconsin, Minnesota, and Arizona have begun to explore ways to improve quality and reduce costs by managing and coordinating health care for dual eligibles.
In announcing the hearing, Chairman Thomas stated: "I strongly support expansion of innovative coordinated care programs, such as PACE and SHMOs. At the same time, I believe we need to look for ways to move beyond existing models to make coordinated care networks a permanent competitive option for all beneficiaries."
FOCUS OF THE HEARING:
The purpose of the hearing is to examine the PACE and SHMO programs, and other efforts to coordinate care for beneficiaries who may be eligible for coverage under both the Medicare and Medicaid programs.
DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:
Any person or organization wishing to submit a written statement for the printed record of the hearing should submit at least six (6) copies of their statement and a 3.5-inch diskette in WordPerfect or ASCII format, with their address and date of hearing noted, by the close of business, Tuesday, May 13, 1997, to A.L. Singleton, Chief of Staff, Committee on Ways and Means, U.S. House of Representatives, 1102 Longworth House Office Building, Washington, D.C. 20515. If those filing written statements wish to have their statements distributed to the press and interested public at the hearing, they may deliver 200 additional copies for this purpose to the Subcommittee on Health office, room 1136 Longworth House Office Building, at least one hour before the hearing begins.
FORMATTING REQUIREMENTS:
Each statement presented for printing to the Committee by a witness, any written statement or exhibit submitted for the printed record or any written comments in response to a request for written comments must conform to the guidelines listed below. Any statement or exhibit not in compliance with these guidelines will not be printed, but will be maintained in the Committee files for review and use by the Committee.
1. All statements and any accompanying exhibits for printing must be typed in single space on legal-size paper and may not exceed a total of 10 pages including attachments. At the same time written statements are submitted to the Committee, witnesses are now requested to submit their statements on a 3.5-inch diskette in WordPerfect or ASCII format.
2. Copies of whole documents submitted as exhibit material will not be accepted for printing. Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material not meeting these specifications will be maintained in the Committee files for review and use by the Committee.
3. A witness appearing at a public hearing, or submitting a statement for the record of a public hearing, or submitting written comments in response to a published request for comments by the Committee, must include on his statement or submission a list of all clients, persons, or organizations on whose behalf the witness appears.
4. A supplemental sheet must accompany each statement listing the name, full address, a telephone number where the witness or the designated representative may be reached and a topical outline or summary of the comments and recommendations in the full statement. This supplemental sheet will not be included in the printed record.
The above restrictions and limitations apply only to material being submitted for printing. Statements and exhibits or supplementary material submitted solely for distribution to the Members, the press and the public during the course of a public hearing may be submitted in other forms.
The
Committee seeks to make its facilities accessible to persons with
disabilities. If you are in need of special accommodations, please
call 202-225-1721 or 202-226-3411 TTD/TTY in advance of the event
(four business days notice is requested). Questions with regard to
special accommodation needs in general (including availability of
Committee materials in alternative formats) may be directed to the
Committee as noted above.