Statement attributable to:
George M. Abraham, MD, MPH, MACP, FIDSA
President, 管家婆心水论坛
WASHINGTON, D.C. October 20, 2021 鈥揟he new strategy paper that the Centers for Medicare and Medicaid Services (CMS) released this afternoon with their vision for the future of the Center for Medicare and Medicaid Innovation (CMMI) is a promising direction. The strategy outlined for CMMI is closely aligned with ACP鈥檚 own objectives for the future of health care. Specifically, the agency鈥檚 priorities are in agreement with many of the solutions that ACP proposes in our Vision for the U.S. Health Care System that was released last year, and with our framework to understand and address disparities and discrimination that was released earlier this year. We appreciate their focus on access and equity, the inclusion of a focus on underserved populations and the clinicians who care for them is important. As ACP stated in our paper on , 鈥減oorly designed value-based payment models have the potential to exacerbate health inequities, particularly models that feature patient cost-sharing or those that are available only in certain, typically more urban, geographic regions. Practices and health systems that care for vulnerable patient populations must be supported rather than penalized.鈥 Primary care physicians and improving support for them could be key to helping those populations, since they have been demonstrated to provide patients with better outcomes at lower costs. That is why ACP was particularly supportive of the mention of working to increase primary care engagement.
Related, the strategy also recommends offering greater opportunities for specialists to engage in models. These ideas are closely aligned with an alternative payment model that ACP and the National Committee for Quality Assurance developed jointly, and which has been recommended by the Physician-Focused Payment Model Technical Advisory Committee (PTAC), the Medical Home Neighborhood.
ACP appreciates the strategy鈥檚 acknowledgement of the need to reduce unnecessary administrative burdens and provide increased support to participants in programs to test new models of care, including access to timely data sharing and data transparency. Moving forward, we will be carefully watching how the agency proceeds with mandatory models. While the paper indicated CMMI wants to examine whether mandatory models can increase quality and access, they can also place undue burden on the physicians and other clinicians who are forced to move forward with models that might not make sense for their practices or patient populations.
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