White paper detailing how the CMS Innovation Center will develop and test new payment and delivery models is in alignment with many ACP policies
Feb. 4, 2022 (ACP)—The Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI), which investigates better ways to reimburse medical professionals, detailed a new vision for the future in a strategy paper released in October, which is closely aligned with the policies of the American College of Physicians.
The CMMI white paper generally reflects ACP priorities regarding the future of the American health care system, said Nadia Daneshvar, an ACP associate of health IT policy. “The shift to value-based care is long overdue,” she said, “and we hope the center will take time to carefully consider our comments and recommendations for improving their strategy and aligning it more closely with the needs of clinicians and their patients.”
The CMMI was established through the Affordable Care Act. Its mission is to develop and test new health care payment and delivery models that improve quality of care, mitigate costs and reformulate payment systems to incentivize patient-centered practices in Medicare, Medicaid and the Children's Health Insurance Program, Daneshvar said. CMMI is also heavily involved in implementation of the Medicare Quality Payment Program, which rewards physicians for providing “high-quality and cost-efficient care.”
In the paper, CMMI announced it will evaluate more aspects of proposed payment systems, such as equity, care delivery transformation, patient outcomes and market characteristics. It also wants to reduce complexity in payment models, streamline participation requirements and reduce administrative burden.
On Jan. 12, ACP sent a 19-page letter to the CMS administrator expressing the ACP perspective on the future of the CMMI. Dr. William Fox, ACP chair of the Medical Practice and Quality Committee, wrote that ACP is “very pleased” to find many parallels between the CMMI strategies and ACP recommendations as addressed in two ACP policy papers: the 2020 “Vision for the U.S. Health Care System” and the 2021 “Comprehensive Framework to Address Disparities and Discrimination in Health Care.”
“Of course, our support also depends on how the execution of these strategies goes,” Daneshvar cautioned. “Sometimes implementation can look very different from what is planned. And as usual, the devil is in the details.”
Daneshvar added that ACP is also “extremely pleased” that CMMI will be reexamining its activities with a major focus on value-based care. ACP is in favor of the CMMI shift to using broader measures of model success, “especially health equity and person-centered care, instead of relying almost exclusively on its original metric of improved quality while either maintaining or reducing cost, or reduced cost while maintaining or improving quality,” she said.
However, “while ACP understands and agrees with the broader metrics the Innovation Center will be using to supplement its assessment of models—e.g., impacts on health equity, person-centered care and health system transformation—ACP does not support the continued use of cost of care as the most fundamental metric,” Daneshvar said.
Reducing administrative burden is currently a top priority for ACP. “While ACP supports many of the Innovation Center's strategic objectives, we emphasize that any new models should increase quality and access without imposing undue burdens on clinicians and other medical professionals,” Daneshvar said. “On a related note, we hope the Innovation Center does not introduce mandatory models prematurely.”
For now, she said, “we thank the Innovation Center for outlining its strategic plan for the next decade and for the opportunity to provide feedback on the white paper.”