HLC Newsletter

Patient, Physician, Hospital Groups Send HHS Secretary Price, Congress Principles to Improve Center for Medicare and Medicaid Innovation

More Than 35 National Organizations Call for Limited Scale Testing, Voluntary Participation in Demonstration Projects, Greater Transparency and Collaboration with Private Sector

WASHINGTON, DC – Addressing widespread concerns about the Center for Medicare and Medicaid Innovation (CMMI) while insisting that a mechanism for exploring new healthcare delivery and payment concepts remains essential, a coalition representing patients, hospitals, physicians, and healthcare leaders has provided new HHS Secretary Tom Price and congressional leaders a set of principles to guide future testing.

The coalition, Healthcare Leaders for Accountable Innovation in Medicare, is calling for a CMMI that, among other improvements and safeguards, engages in appropriately-scaled, time-limited demonstration projects, greater transparency, improved data-sharing, and broader collaboration with the private sector.  Participation in CMMI demonstration projects must be voluntary for healthcare providers, and beneficiaries must be adequately educated about projects with assurances that their care quality and access will not be adversely affected.

“Our healthcare system is transitioning, as it should, from fee-for-service to value-based care, and that requires the testing of new ideas to make healthcare more quality-driven, cost-effective, and patient-centered,” said Mary R. Grealy, president of the Healthcare Leadership Council.  “We need a CMMI, but we also need safeguards to ensure that CMMI adheres to its original intent, that it test innovative payment and delivery approaches without harm to those who deliver and receive healthcare.”

The principles call for CMMI to:

  • Foster strong scientifically-valid testing prior to expansion. CMMI experiments should have comprehensive, methodologically sound, transparent evaluation plans and occur via appropriately-scaled, time-limited tests.  Participation in model tests must be voluntary.
  • Respect Congress’s role in making health policy changes. Congress must oversee CMMI and approve model expansions and related changes to Medicare and Medicaid.
  • Consistently provide transparency and meaningful stakeholder engagement. CMMI’s process for developing, testing, and expanding models must be more open, transparent and predictable to provide meaningful opportunities for stakeholder input.
  • Improve data sharing from CMMI testing. Data from CMMI model tests should be made public – enabling assessments of their impact on care quality and spending and to inform similar efforts in the private sector.
  • Strengthen beneficiary safeguards. Patients must be adequately educated about new demonstration projects and their continued care access and quality ensured.
  • Collaborate with the private sector. In selecting demonstration projects, CMMI should give priority to partnerships involving providers, payers, and other private sector entities, harnessing market competition and innovation to have an optimal impact on healthcare quality and cost-efficiency.

Angus Worthing, MD, a practicing rheumatologist and chair of the American College of Rheumatology’s government affairs committee said, “These principles will go a long way toward focusing the important work of CMMI on appropriately-scaled projects that align Medicare payment structures with our patients’ healthcare needs.  The American College of Rheumatology supports fully transparent, innovative, data-driven ways to make healthcare more valuable and accessible to our patients.”

To learn more, visit ProtectingMedicareAccess.com.

Contact: Will Walters, 202-868-4821