The Healthcare Leaders for Accountable Innovation in Medicare, a coalition of organizations from across the healthcare spectrum, has provided new HHS Secretary Tom Price and congressional leaders a set of principles to guide Center for Medicare and Medicaid Innovation (CMMI) future testing and address concerns related to the agency.
The coalition 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,” the coalition stated. The coalition is specifically representative of patients, hospitals, physicians, and healthcare leaders.
The principles more specifically 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 have 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.
“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,” Mary R. Grealy, president of the Healthcare Leadership Council, said in a statement. “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.”
CMMI has been questioned in the past by House Republicans, including Price, for overstepping its definition in statutes. In Senate hearings this past month, Price has said that CMMI has “gotten off track.” He specifically said, “Innovation is so incredibly important to healthcare…innovation is in fact what leads quality healthcare and expands the ability of healthcare professionals to be able to treat patients. I’m a strong supporter of innovation and we need to incentivize innovation. CMMI is a vehicle that might do just that, however, it’s gotten off track into defined areas where it is mandatorily dictating to providers how they must practice.”