Poll of 2,000 registered voters finds most Americans want to decide the best course of treatment with their doctors and oppose government intervention in medical care as proposed by CMS
CMS’ Proposed Use of Comparative and Cost-Effectiveness Standards: What It Means for Patients4/8/2016
On March 8, 2016, the Center for Medicare and Medicaid Services (CMS) proposed a new Part B Drug Payment Model. Among its provisions, the proposal calls for use of comparative effectiveness research (CER) and cost-effectiveness reports as the basis for national Medicare policy, in direct conflict with the patient-centeredness movement. Since its inception, the Partnership to Improve Patient Care (PIPC) has been strongly opposed to misuse of CER and cost effectiveness in government policies. This proposal appears to have been rushed forward with little or no patient input. The phase involving centralized use of CER and cost-effectiveness begins early in 2017, eventually covering 50% of providers and patients, leaving little time for meaningful patient engagement.
On March 8, 2016, the Center for Medicare and Medicaid Services (CMS) proposed a new Part B Drug Payment Model calling for centralized use of comparative effectiveness and cost-effectiveness reports as the basis for national Medicare policy. The Partnership to Improve Patient Care (PIPC) is strongly opposed to the approach outlined by CMS and asks asks all stakeholders to alert Congress to the serious concerns brought on by CMS' proposed Part B Drug Payment Model.
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? 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? Many people want to quantify “value” in health care. But for the ultimate beneficiary, the patient, value is more personal. That doesn’t mean we can’t get better value, it just requires us to find ways that respect patients and their diverse care needs and preferences. This was the big message I took away from a roundtable recently convened by the Partnership to Improve Patient Care (PIPC) and the Cancer Support Community (CSC) with many leading organizations representing cancer patients.
After five years of progress towards patient-centered comparative effectiveness research (CER), the Center for American Progress (CAP) threatens to unwind it by reviving the old debate over using CER to control medical spending. 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.
The Partnership to Improve Patient Care (PIPC) today released a detailed summary and recommendations from an expert roundtable it convened April 15 of this year to explore strategies for engaging and empowering patients in care delivery. Convened by PIPC Chairman Tony Coelho, the roundtable consisted of 17 thought-leaders in the area of patient engagement and activation, all of whom shared their concerns about the existing health care infrastructure for meaningful patient and beneficiary engagement, and provided ideas for improvement.
MedPAC Explores Fixes To Part B Drug Payment Policy, Calls Current System 'Perverse Incentive'11/12/2014
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.
PIPC is deeply concerned about MedPAC’s discussion of giving CMS new authority to make “least costly alternative” judgments about patient treatment options. PIPC fought hard for patient protections in the Affordable Care Act that ensure CMS does not misuse comparative effectiveness research to impose “one-size-fits-all” coverage or payment policies. LCA could undercut these protections and prevent doctors and patients from making informed decisions about the treatment option that is best for the individual patient. We urge MedPAC not to move forward in recommending new LCA authority for CMS.
Today, the Medicare Payment Advisory Commission (MedPAC) convened for the first day of their March public meetings. Among their deliberations, the Commission considered developing payment policy to promote use of services based on clinical evidence. Discussion focused predominately on proposals to apply the defunct least costly alternative (LCA) policy to Medicare Part B drugs.
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