New Nutrition Benefit Under Medicare Could Reduce Costs

On Jan. 1, Medicare expanded coverage of medical nutrition counseling -- "consultation with dietitians about what to eat" -- for nearly five million beneficiaries with diabetes or kidney disease, a move that some experts hope will have a "significant impact" on medical costs and "open the door" for "broader" coverage of preventive care, the Washington Post reports. Previously, Medicare only covered nutrition counseling for a small number of beneficiaries with "dire health problems," including people with uncontrolled diabetes and patients needing dialysis. Under the expanded benefit, 4.5 million beneficiaries with diabetes and 110,000 beneficiaries with kidney disease will qualify for nutrition counseling at a cost of $270 million "over the first five years." The Post reports that nutrition counseling allows beneficiaries to meet "one-on-one" with a registered dietitian to discuss "food intake" and exercise, review lab tests and "set goals for making dietary changes." Based on recommendations by the Institute of Medicine, which conducted a study that found that nutrition counseling was "cost-effective" for seniors and "improved their quality of life," officials decided to expand coverage provided that counseling was limited to beneficiaries with diabetes or kidney disease, offered by registered dietitians and prescribed by a physician. Sean Tunis, CMS director of coverage and analysis, said that the number of counseling sessions allowed under the new benefit "is still pending," but the Post reports that it could include an "average of four visits per year."

Cindy Moore, an American Dietetic Association spokesperson, said, "In the past, the government and other private insurers covered these very expensive procedures that resulted from disease," while less expensive preventive services went uncovered. According to the Post, if the program successfully reduces medical costs, the nutrition counseling benefit could be expanded to include more Medicare beneficiaries. HHS will monitor the use of nutrition counseling and "advise" Congress on the possibility of covering beneficiaries with high blood pressure, heart disease, osteoporosis and cancer. Moore said, "If someone is able to understand the relationship of the food choices they make with their disease, they are empowered to be better able to control their disease. That means they are going to delay and even offset some of the complications. The end result is less cost to taxpayers" (Squires, Washington Post, 1/29).