[Congressional Record (Bound Edition), Volume 160 (2014), Part 7]
[Extensions of Remarks]
[Page 9298]
[From the U.S. Government Publishing Office, www.gpo.gov]




       INTRODUCTION OF THE MEDICARE TRANSITIONAL CARE ACT OF 2014

                                 ______
                                 

                          HON. EARL BLUMENAUER

                               of oregon

                    in the house of representatives

                         Thursday, May 29, 2014

  Mr. BLUMENAUER. Mr. Speaker, today I am introducing The Medicare 
Transitional Care Act, which will address continuity of care problems. 
This legislation will provide high-risk Medicare beneficiaries access 
to evidence based transitional care services that are provided by an 
eligible transitional care entity, such as hospitals, skilled nursing 
facilities, and community based-organizations. The bill will also 
provide incentives for the use of technology and other tools to improve 
care transitions.
  Transitions from hospital to home can be complicated and risky, 
especially for individuals with multiple chronic illnesses. Patients 
frequently report difficulty remembering clinical instructions, 
confusion over correct use of medications, and uncertainty over their 
prognosis. In cases where multiple providers are involved, patients 
often get conflicting instructions from different providers.
  Researchers with the Robert Wood Johnson Foundation have estimated 
that inadequate care coordination, including inadequate management of 
care transitions, was responsible for $25 to $45 billion in wasteful 
spending in 2011 through avoidable complications and unnecessary 
hospital readmissions.
  In its June 2012 Report, Medicare Payment Advisory Commission 
(MedPAC) highlighted the need for an explicit payment for transitional 
care services, given the documented evidence that effective and 
coordinated care transitions improve health outcomes, reduce 
readmission rates, and generate significant savings to the U.S. health 
care system. The Congressional Budget Office has echoed these findings. 
In a report documenting lessons from Medicare's demonstration projects, 
the CBO emphasized that ``programs that smoothed transitions (for 
example, by providing additional education and support to patients 
moving from a hospital to a nursing facility or between a primary care 
provider and a specialist) tended to have fewer hospital admissions.''
  It is our hope that stakeholders involved in the care delivery system 
will carefully evaluate this legislation and provide comments or 
suggested improvements to me and the other sponsors. We are interested 
in ensuring that the legislation's terms are adequately tailored to the 
different circumstances and settings in which these transitions occur.
  Providing a transitional care benefit within Medicare will help 
coordinate care, develop a care plan for patients and their caregivers, 
identify potential health risks, and prevent unnecessary 
hospitalizations. I thank my cosponsors and look forward to working 
with my colleagues to advance this legislation.

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