This morning's edition of Politico Pulse highlighted the Partnership to Improve Patient Care's (PIPC) leadership among patient groups in voicing concerns over Phase 2 of the Centers for Medicare and Medicaid Services (CMS) planned Part B demonstration project. PIPC, along with over 40 other groups, are sending a letter to CMS acting administrator Andy Slavitt highlighting issues with the proposed change to lower the add-on payment for drugs in phase 2 of the proposed demo.
An article posted today in The Wall Street Journal outlined lawmakers' concerns with the Centers for Medicare and Medicaid Services' (CMS) recent proposal to reduce Medicare's profit incentives to doctors who administer drugs. WSJ notes bipartisan concerns with the program, including the demands of dozens of House Republicans for the proposal to be withdrawn.
Over the last few years, I’ve been very outspoken on the need to engage patients and people with disabilities in efforts to define the value of health care. Engagement has become my ministry because, frankly, what we often find is “token” engagement - a pat on the head, with no real impact on policy development and implementation. I thought we were making real progress on engagement in this administration. It seems I was wrong.
What's the most important question facing any patient with a life-threatening illness?
"Which treatment option is best for me?"
By most accounts, this is a good problem to have; giving patients a range of treatment options, and the ability to make an informed choice about the regimen that most directly aligns with their personal health priorities is fundamental to high-quality, individualized health care. But along with these new methods for treatment come difficult questions. Do I want the more aggressive or conservative therapy? Is my quality of life during treatment more important than returning to work quickly? Which course of action has more tolerable side effects? Can I afford the care I need?
PIPC Chairman Tony Coelho recently wrote an op-ed for Morning Consult discussing the Partnership's recent oncology roundtable and arguing that value-based healthcare discussions need to include patient-centeredness. As Chairman Coelho concludes, "Our healthcare system will never know how to measure and reward quaity if we don't ask patients what they value. Patients are ready to move towards better value, but to get there, you need to put us in the driver's seat."
In a new op-ed published in Roll Call, PIPC Chairman Tony Coelho weighs in on the debate of using comparative effectiveness research (CER) to control medical spending. Chairman Coehlo emphasizes that "proposals for Medicare and private payers to use CER are understandable, but concerning. Understandable because the challenge of rising costs is real, and policy-makers naturally reach for familiar policy tools. Concerning because it would pull CER away from individualized patient decisions and back towards centralized payer decisions. The end result would be limited choice of treatments based on one-size-fits-all determinations of 'value' for the average patient."
In a recent column posted in Morning Consult, PIPC Chairman Tony Coelho writes about the conclusions drawn from the PIPC Roundtable Discussion held in June and what they mean for the future of patient engagement in alternative payment models (APMs). Chairman Coelho noted that the Roundtable Discussion highlighted a "remarkable consensus on commonsense, workable approaches that can ensure that the widespread adoption of alternative payment models will serve to empower patients and draw them towards the center of care delivery." The full column "Strategies to Engage and Empower the Patient in Care Delivery: Just Ask the Patient" can be found on the Morning Consult website.
Inside Health Policy: 'Patient Groups Seek Key Role In Health Care Payment Learning And Action Network'
As highlighted in an article in Inside Health Policy, "more than 60 patient groups and members of [PIPC] are asking HHS to make the Health Care Payment Learning and Action Network patient-centered by including patient groups in the network and using best practices from the FDA and Patient-Centered Outcomes Research Institute to solicit patient engagement with the initiative." While most patient stakeholders agree that paying for “value” rather than “volume” will result in better outcomes for patients, the shift to value-based payment holds significant implications for the patient-centeredness movement and the related issues of patient access and the physician-patient relationship. That’s why PIPC led this letter - to ensure that that patients have a seat at the table in determining how these new payment models are implemented.
“I look forward to collaborating with HHS to effectively bring the patient voice to their ambitious new framework to move our health care system away from rewarding health providers for the quantity of care they provide and toward rewarding quality. Empowering patients to play an active role in their healthcare should be a strategic and achievable goal of this important work,” Partnership chair Tony Coelho told Inside Health Policy.
Today, PIPC Chairman Tony Coelho was quoted in a piece by Inside Health Policy regarding Medicare Part B's drug payment policy. The Congressional commission, Medicare Payment Advisory Commission (MedPC), recently discussed support, from a small number of commissioners, for allowing CMS to return to the controversial “least costly alternative” model it used from 2005 to 2010 that MedPAC discussed at its September meeting. “As the Commission moves forward in their deliberations to improve outcomes and reduce costs in the Medicare program, PIPC hopes that MedPAC will pursue policies that activate patients and lead to long-term health improvements, rather than focusing on those that could threaten to jeopardize the nature of the doctor-patient relationship,” said Chairman Coelho.
Today, Health Affairs published an opinion piece written by Chairman Coelho to announce the release of PIPC's new White Paper on patient-centeredness in alternative payment models (APMs). Chairman Coelho wrote the op-ed to highlight the importance of building APMs on a foundation of patient-centeredness throughout the healthcare system. This White Paper and Health Affairs opinion represent an important step in PIPC’s discussion of the application of comparative effectiveness research, and should serve as an important tool for policymakers in considering the future of value-based payment models.
In a recent article published in the HeraldNet, PIPC Chairman Tony Coelho was quoted regarding changes to regulations made by the Department of Labor. New rules implementing a section of the federal Rehabilitation Act now prohibits discrimination on the basis of disabilities. "Because of the new regulations, up to 465,000 people living with a disability may have a chance at gaining employment within the next year, according to Tony Coelho, the primary sponsor of the Americans with Disabilities Act and former California congressman. The act, which prohibits discrimination based on disability, was enacted by Congress in 1990.'In my view, it’s a real game-changer,' Coelho said. 'For those of us with disabilities, a job is what’s critical.'"
In an opinion article published in Roll Call, PIPC Chairman Tony Coelho discusses how patients will compare treatment options utilizing the results of comparative effectiveness research. Chairman Coelho writes, "central to this mission is doing research on the questions that matter to patients, engaging patients and physicians in their decision-making and communicating research findings in a way that helps doctors and patients make good health care decisions." He goes on to note that patients and clinical experts should be partners with PCORI as they develop protocols for communicating research findings in a manner that people find useful in their decision-making.
In an article published in Inside Health Policy, Partnership to Improve Patient Care (PIPC) Chair Tony Coelho reacts to PIPC's absence from PCORI's roundtable on data dissemination, as well as a new poll which highlights the need to communicate research with the patient community. According to the article, "[Chairman] Coelho says PCORI is not involving enough patient representatives in PCORI's work to disseminate comparative effectiveness research findings, but a spokesperson for the Patient-Centered Outcomes Research Institute says the July 29 roundtable on CER dissemination includes representatives from patient, caregiver and consumers organizations, including a PIPC member organization. PCORI is holding a roundtable on Monday (July 29) to plan for communicating CER findings to the public, and PIPC was not invited, despite several requests to participate, Coelho says. Coehlo says the roundtable should include more patient representatives, and PCORI indicated to him that including consumer representatives satisfies the requirement to get patient input.
In letter to the editor in response to a recent New York Times op-ed, PIPC Chairman Tony Coelho writes that PIPC cautions against one-size fits all solutions to patient care. "Physicians are very capable of weighing the evidence and individualizing care based on it. It would be a mistake to expand high-cost programs like 'counter detailing' that outsource that judgment and impose 'one size fits all' recommendations based on the assumption that doctors are not capable of making their own judgments," Coehlo writes. "As a person with epilepsy, I know that one size does not fit all, and I know the importance of good decision-support tools."
The San Jose Mercury News recently published an article on the promise - and the concerns - of comparative effectiveness research as overseen by the Patient Centered Outcomes Research Institute (PCORI):
"Critics said they fear [comparative effectiveness] research could lead to health care rationing if the government uses the results to ax effective treatments simply because they cost too much. To address such criticisms, legislation discouraged the new institute from doing cost comparisons. That has erased many of the concerns initially raised by groups such as the Partnership to Improve Patient Care, a private organization formed in 2008 that includes representatives of drug manufacturers, device-makers and patient groups. Now the group's chairman, former Rep. Tony Coelho, a Democrat who represented the San Joaquin Valley area, said he wants to make sure that patients are involved in the new institute's decision-making and that doctors and patients can understand the research findings."