Smith Introduces Bill to Protect
Health Care Options for Seniors
Bill Will Protect Social HMOs
WASHINGTON, D.C.–Senator Gordon Smith (R-OR) today introduced the Seniors Health and Independence Preservation Act of 2003 (S. 306). The bill seeks to make permanent several Social Health Maintenance Organization (HMO) demonstration projects that provide seniors with specialized care. Of particular importance to Oregon's seniors, a key provision in the bill makes Kaiser's Social HMO program permanent.
"Social HMOs represent a meaningful model for Medicare modernization without breaking the bank," said Smith. "Social HMOs respond to seniors' needs by allowing them to maintain independence and avoid nursing home placement."
Social HMOs began as a pilot program created by Congress as part of the 1984 Deficit Reduction Act. They were intended to explore ways to improve care and reduce costs for those served by Medicare. Several recent studies have shown that Social HMO members are 40 to 50 percent less likely to have long-term nursing home placements than comparison group members. Further, in a recent survey of Social HMO beneficiaries, over three-quarters of respondents indicated that the special services offered by their Social HMO were important to allowing them to remain independent.
Those special benefits include:
Prescription drugs with modest copayments.
An annual benefit of up to $12,000 for expanded care services such as adult day care, personal care, meals, and transportation.
Payment for up to 14 days of custodial nursing facility care for each period of confinement to aid members in returning to the community.
Senior Advantage II, offered by Kaiser Permanente's Northwest Division, is one of the four original Social HMOs that were approved as part of the initial Medicare demonstration project. Advantage II currently serves about 4,300 Medicare beneficiaries in the Northwest with its primary service area in Portland.
Oregon Senator Ron Wyden and Washington State Senators Patty Murray and Maria Cantwell are cosponsoring Smith's legislation.
