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Partnership to Fight Chronic Disease Healthy Aging Event - Robert Blancato

Partnership to Fight Chronic Disease Healthy Aging Event - Robert Blancato

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Dec. 11th PFCD event.
Dec. 11th PFCD event.

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Published by: Partnership to Fight Chronic Disease on Dec 13, 2012
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Partnership to Fight Chronic Disease Healthy Aging Event

Robert Blancato Executive Director, NANASP www.nanasp.org

• I am pleased to be here on behalf of the National Association of Nutrition and Aging Services Programs. • We represent more than 1000 members across the nation who are serving meals and providing nutrition education to millions of older adults. • We work with older adults each and every day and we know of their strong interest in Medicare. • Our members helped to ensure low income seniors did enroll in Medicare Part D when program began.

• In the area of lowering costs associated with chronic diseases and Medicare, we hope that any entitlement reform leads to greater focus on coordinating care at lower cost to those with one or more chronic conditions. • I want to focus in two places in this discussion
– The importance of nutrition—the need to invest more in nutrition – And the value to date of Medicare Part D

Chronic Disease and Nutrition
• On the nutrition side, research done by the Academy of Nutrition and Dietetics revealed that 87 percent of older adults have one or more of the most common chronic diseases hypertension, diabetes and coronary heart disease which they contend are preventable and treatable in part with access to appropriate nutrition services.

Nutrition and Health
• Dehydration and pressure ulcers are directly associated with nutritional status and are among the top reasons older adults are admitted to the hospital. • Further, according to NASUAD which represents state units on aging, without proper nutrition people are more prone to falls which result in costly hospitalizations and are linked to 40 percent of nursing home admissions with direct medical costs in excess of $19 billion.

Coverage for Nutrition Therapy
• Medicare only in recent years has begun to provide coverage for medical nutrition therapy which is considered reasonable and necessary for illness prevention. They are limited to diabetes and non dialysis kidney disease. • Legislation has been offered in the past to extend and we would be interested and supportive of an expansion and obviously opposed to any effort to reduce or eliminate.

Older Americans Act
• A related point to make relates to the Older Americans Act, a program which operates in virtually all Congressional districts and states. • Its largest program is its nutrition program which provides its participants with daily meals both in the congregate and home delivered setting. • All told, meals are served to 2.6 million seniors 60 and over daily.

Program Savings
• The important relationship here is that participants do include those who were assessed of being at risk of a hospitalization or nursing home placement because of their inability to maintain a proper diet. • Some of these same individuals have been in the programs more than ten years—meaning this intervention of nutrition and nutrition education achieved its goal and it is assumed that it produces savings in Medicaid and Medicare.

• So as NANASP has advocated for years, an investment in the Older Americans Act produces this important return—and contributes to healthy aging. • We therefore want to see sequestration avoided at all costs because it would slash funding for the OAA and could result in the loss of 17 million meals for older adults according to HHS.

Medicare Part D
• Wish to focus balance on Medicare Part D which began in 2006 and which helps to pay for prescription drugs provided under private plans that contract with Medicare and which can include stand alone plans and Medicare Advantage plans. • A low income subsidy is provided for enrollees.

Part D Successes
• There are a number of successes associated with Part D to date including:
– its overall costs have come in lower than projected – premiums have remained stable – it enjoys a satisfaction rate of close to 90 percent among its participants

Part D Saves Money
• But more relevant to today’s discussion is the fact that according to a study in the Journal of the American Medical Association improved access and adherence to medicines driven by Part D saves about $1200 per Medicare beneficiary in hospitals, skilled nursing facilities and other costs for each senior who lacked prescription coverage before Part D.

Part D Saves Lives
• In addition as Ken has pointed out the November 29 CBO report showed an important relationship between an increase in prescription drug use and a drop in other medical spending including and especially hospitalizations. • Improved medication adherence related to Part D can also lead to a lack of unnecessary disease progression and disease complications.

Part D Should Not Be Weakened
• So in the upcoming debate on the future of Medicare—the Part D program should not be weakened. Part D combined with the Affordable Care Act reducing the donut hole is achieving real savings for seniors. It is promoting better medication adherence and lowering costs in other areas of Medicare.

Mandatory Rebates and Higher Costs
• In particular NANASP was pleased to join on a letter authored by the Council for Affordable Health Coverage to oppose any effort to impose new mandatory rebates on the pharmaceutical industry • We believe it undermines the Part D Program as it can be expected to result in higher premiums, more limited choices, and cost shifting to other Medicare Part D beneficiaries. Higher premiums and cost sharing could lead to older people leaving the program and the important coverage it provides potentially leading to higher Medicare costs in the future.

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