Patients, Providers, and Healthcare Leaders Call for Improvements to Center for Medicare & Medicaid Innovation

WASHINGTON, DC – A new coalition of groups representing patients, hospitals, physicians, and  healthcare leaders is calling for the Center for Medicare & Medicaid Innovation (CMMI) to refine and improve its efforts to spur innovation in healthcare by addressing growing concerns about the scope of demonstration projects initiated by CMMI, their impact on patients, and the agency’s level of transparency.

At the announcement, the Healthcare Leadership Council released a white paper on “Reforms to Strengthen and Sustain CMMI.”  That paper can be found here.

The coalition, Healthcare Leaders for Accountable Innovation in Medicare, supports CMMI’s role to develop, test and share promising new ideas for improving care and lowering costs.  The Coalition says, however, that the agency Center needs stronger public-private collaboration with key healthcare stakeholders and should conduct demonstration projects that are reasonably limited in scope and do not apply untested changes to large portions of our healthcare system and millions of patients.

Key priorities cited by the coalition include:

• Limiting the scope and scale of demonstration projects to levels that allow for statistically-significant samples without impacting larger segments of patients and providers.
• Ensuring greater transparency and meaningful stakeholder engagement in collecting input on potential demonstrations, and making data from pilot projects readily accessible.
• Ensuring effective quality measurement tools are in place to monitor the results of new models and protect patients from unexpected consequences.
• Ensuring Congress is able to effectively monitor the workings of CMMI and fulfill its own constitutional role to approve permanent changes in Medicare policy.

“We want CMMI to be an effective agent of change and a catalyst for health system improvement.  This coalition’s purpose is to advocate for reforms to protect patients and healthcare providers and better enable the Center to fulfill its intended mission,” said Mary R. Grealy, president of the Healthcare Leadership Council.  “Large scale payment and delivery models that cover much of the country create greater risks for Medicare beneficiaries and compliance challenges for providers, who face overlapping and competing demonstration projects.  Clearly, we need more consistent collaboration between CMMI and those affected by its decisions, which involves greater transparency and data sharing.”

The coalition raised concerns about CMMI projects like the Comprehensive Care for Joint Replacement Model, the Part B Drug Payment Model, and the Cardiac Bundled Payment Model that, Ms. Grealy said, exceed the common understanding of what constitutes limited scale testing.

Representatives of the Arthritis Foundation and the National Minority Quality Forum, both coalition members, spoke at the organization’s launch.

“The National Minority Quality Forum (The Forum) is pleased to join the Steering Committee of Healthcare Leaders for Accountable Innovation in Medicare, “ said Gary A. Puckrein, PhD, President and CEO of The Forum. “The Forum’s overarching concern is patient safety. Patient safety must be paramount, and must be protected in a manner that is consistent with the principles embodied in the Common Rule, the Federal Policy for the Protection of Human Subjects. Whether the demonstration or model is associated with coverage and payment policy, or clinical diagnosis and treatment guidelines, failure to assign the highest priority to beneficiary protection enables an unacceptable risk for harm that is untenable.”

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Healthcare Leaders for Accountable Innovation in Medicare

• American College of Rheumatology
• American Health Care Association / National Center for Assisted Living
• AMGA
• Arthritis Foundation
• CAPG
• Coalition of State Rheumatology Organizations
• Federation of American Hospitals
• Healthcare Leadership Council
• National Alliance on Mental Illness
• National Association of ACOs
• National Council of Asian Pacific Islander Physicians
• National Hispanic Medical Association
• National Minority Quality Forum
• Pharmaceutical Research and Manufacturers of America
• The Society of Thoracic Surgeons
• The US Oncology Network