At a hearing on May 14, Senate Finance Committee Chairman Orrin Hatch, R-Utah, and Ranking Member Ron Wyden, D-Ore., announced a plan for the committee to address Medicare spending on treating multiple chronic illnesses, which accounts for the majority of the program’s expenditures. Spending on chronic illnesses accounts for approximately 93% of Medicare spending, the Senators said.

"Chronically ill patients account for a large percentage of Medicare spending. In 2010, more than two-thirds of Medicare beneficiaries had multiple chronic conditions, while 14% had six or more," Hatch said.  "Beneficiaries with six or more chronic conditions accounted for 46%of all Medicare spending. In fact, fee-for-service Medicare spent an average of more than $32,000 per beneficiary with six or more chronic conditions compared to an average of around $9,000 for all other patients."

Hatch and Wyden announced the formation of a working group to develop policy ideas for the committee to consider, to be co-chaired by Sens. Johnny Isakson, R-Ga., and Mark Warner, D-Va.,  More information about the working group will be announced at a later time.

At the hearing, the Finance Committee heard testimony from Dr. Patrick Conway, deputy administrator for innovation and quality at the Centers for Medicare & Medicaid Services, and Dr. Mark Miller, the executive director of the Medicare Payment and Advisory Commission (MedPAC), both of whom offered ideas on how Congress can begin addressing chronic illness in Medicare. Their testimony can be found here.

 “Today, the vast majority of Medicare dollars are spent caring for patients living with multiple persistent, chronic health conditions. The variety of services required for this care can often be uncoordinated and costly,”Wyden said.“I commend Chairman Hatch for making this issue a priority for the committee, and I look forward to working with him and all of our colleagues to craft a solution that gets to the heart of this issue.”

The National Kidney Foundation announced its support of the Finance Committee's plan. "CKD is a disease multiplier that leads to cardiovascular disease, bone disease and other chronic conditions," the NKF said in a statement. "Medicare already spends about $87 billion annually to care for patients with kidney disease, including nearly $29 billion for most of the 636,000 individuals with end stage renal disease. As CKD advances from stage 1-4, costs nearly double from one stage to the next."

“Intervention at the earliest stage is vital to improving outcomes, lowering health care costs, and improving patient experience,” said Tonya Saffer, the National Kidney Foundation’s Senior Health Policy Director. “We look forward to working with the Senate Finance Committee and its working group to craft policies to address CKD and chronic disease care and spending.”