Medicare Aims to Improve Coordinating Seniors' Chronic Care

Adjusting medications before someone gets sick enough to visit the doctor. Updating outside specialists so one doctor's prescription doesn't interfere with another's.

Starting this month, Medicare will pay primary care doctors a monthly fee to better coordinate care for the most vulnerable seniors - those with multiple chronic illnesses - even if they don't have a face-to-face exam.

The goal is to help patients stay healthier between doctor visits, and avoid pricey hospitals and nursing homes.

"We all need care coordination. Medicare patients need it more than ever," said Sean Cavanaugh, deputy administrator at the Centers for Medicare and Medicaid Services.

About two-thirds of Medicare beneficiaries have two or more chronic conditions, such as diabetes, heart disease or kidney disease. Their care is infamously fragmented. They tend to visit numerous doctors for different illnesses.

Too often, no one oversees their overall health - making sure multiple treatments don't mix badly, that X-rays and other tests aren't repeated just because one doctor didn't know another already had ordered them, and that nothing falls between the cracks.

Medicare's new fee, which is about $40 a month per qualified patient, marks a big policy shift. Usually, the program pays for services in the doctor's office.