Healthcare leaders call for transparency, timely data in CMMI models
A number of healthcare organizations have responded to the CMS request for information seeking guidance on what the agency says will be “a new direction” for the Center for Medicare and Medicaid Innovation (CMMI).
The American Hospital Association (AHA) said CMMI models should be transparently designed, should minimize regulatory burden and should not include barriers to clinical integration or care coordination.
CMS Administrator Seema Verma has said the administration supports the movement toward value-based payment models, but many supporters of that movement are concerned the CMS is beginning to weaken government-led efforts in that area.
Verma is looking to revamp many pieces of CMS, including the CMMI, while reducing regulatory burdens, providing more flexibility for state Medicaid programs and deciding how best to measure quality without adding work onto providers.
“Our vision is to develop models that promote a patient-centered system of care within a market-driven healthcare system. Models should empower consumers to make decisions that are right for them and providers should compete around value and quality,” she said recently.
Behind Verma’s request for comments about CMMI is CMS’ stance not to have federal officials in Washington set policy in a vacuum. Previous CMMI projects have brought a mixed reaction from providers.
It’s part of a broader concern that HHS under President Donald Trump is shying away from the value-based payment movement altogether. Recently, the CMS announced a plan to eliminate and scale back bundled payment models .
Verma’s request for information asked for input on eight focus areas: increased participation in advanced alternative payment models, consumer-directed care and market-based innovation models, physician specialty models, prescription drug models, Medicare Advantage innovation models, state-based and local innovation, mental and behavioral health models and program integrity.
The Federation of American Hospitals (FAH) agreed with an earlier CMS decision to make certain bundled payment models voluntary and said the agency should not mandate provider participation going forward. FAH and AHA stressed the need for providers to receive timely and relevant data.
The Electronic Health Records Association said its members have firsthand experience in how health IT and EHRs “can play a critical role in delivery system reform and the successful transition to value-based care. This role encompasses both the standardization of data used for evaluating physician performance and facilitating information exchange between providers, patients, and other healthcare stakeholders.”
The American Telemedicine Association promoted telehealth as part of patient-centered care. “Now is a good time for CMS to fully explore consumer-directed, technology-enabled, site-neutral tools of care to meet growing healthcare delivery challenges. Telemedicine tools ensure timely, patient-focused and cost-effective access to an array of healthcare services from qualified health professionals across the entire spectrum of care,” they wrote.
Meanwhile, in a new Health Affairs post, Jeff Micklos and Clare Wrobel from the Health Care Transformation Task Force wrote that the CMMI should “balance promising models with new priorities.”
“Successful organizations are aligning and synchronizing various models to leverage their investments in pursuit of a sustainable business model. Thus, in adopting new models, CMS should follow the lead of vanguard organizations in the private sector and avoid a transition that moves from fee-for-service silos to value-based payment silos,” they wrote.