Partnership to Improve Patient Care

  • Home
  • About
    • Mission and Priorities
    • Meet the Chairman
    • Steering Committee
    • PIPC Member List
    • Contact
  • The Issues
    • Value Our Health
    • International
    • Where We Stand
    • Value Assessment Frameworks
    • Engaging Patients in Value-Based Payment
    • Patient-Centeredness in Research
  • Resources
    • Advocacy
    • Letters and Comments
    • PCORI Meeting Transcripts
    • Polling
    • Roundtables
    • White Papers
  • Blog
    • PIPC Patients' Blog
    • Chairman's Corner
    • PIPC Weekly Update
    • The Data Mine
  • Newsroom
    • PIPC in the News
    • Press Releases
    • Open Letter: We Deserve a Voice
  • Events
    • PIPC Forum 2022
    • Discrimination & Health Care
    • C & GT Webinar
    • ICER COVID Webinar
    • Value Our Health Briefing
    • QALY Briefing
    • QALY Panel
    • Past Webinars >
      • ICER SCD Webinar
      • VOH Sickle Cell Webinar
      • Rare Disease Webinar
      • QALY Webinar
      • PCORI Advocacy Webinar
      • APM Webinar
      • Patient Empowerment Webinar
      • Value Assessments Briefing
    • Past PIPC Forums >
      • 2021
      • 2020
      • 2019
      • 2018
      • 2017
      • 2016
      • 2015
      • 2014
      • 2013
      • 2012
      • 2011
      • 2010
  • Home
  • About
    • Mission and Priorities
    • Meet the Chairman
    • Steering Committee
    • PIPC Member List
    • Contact
  • The Issues
    • Value Our Health
    • International
    • Where We Stand
    • Value Assessment Frameworks
    • Engaging Patients in Value-Based Payment
    • Patient-Centeredness in Research
  • Resources
    • Advocacy
    • Letters and Comments
    • PCORI Meeting Transcripts
    • Polling
    • Roundtables
    • White Papers
  • Blog
    • PIPC Patients' Blog
    • Chairman's Corner
    • PIPC Weekly Update
    • The Data Mine
  • Newsroom
    • PIPC in the News
    • Press Releases
    • Open Letter: We Deserve a Voice
  • Events
    • PIPC Forum 2022
    • Discrimination & Health Care
    • C & GT Webinar
    • ICER COVID Webinar
    • Value Our Health Briefing
    • QALY Briefing
    • QALY Panel
    • Past Webinars >
      • ICER SCD Webinar
      • VOH Sickle Cell Webinar
      • Rare Disease Webinar
      • QALY Webinar
      • PCORI Advocacy Webinar
      • APM Webinar
      • Patient Empowerment Webinar
      • Value Assessments Briefing
    • Past PIPC Forums >
      • 2021
      • 2020
      • 2019
      • 2018
      • 2017
      • 2016
      • 2015
      • 2014
      • 2013
      • 2012
      • 2011
      • 2010

The PIPC Blog

Chairman's Corner: Examining Episode Payment Models

4/28/2017

 
Picture
​​On April 19, 2017, I provided comments to the Centers for Medicare and Medicaid Innovation (CMMI) on behalf of the Partnership to Improve Patient Care (PIPC) related to some new, recently proposed episode payment models.  I applauded the agency for making a deliberate and conscious effort to solicit authentic patient feedback about their proposed new payment models. Although I’ve been critical in the past, I told them that I appreciated their seizing of this opportunity to forge a new path forward on engaging stakeholders, particularly patients, in the development, implementation and evaluation of alternative payment models.

Last December, PIPC issued a report entitled, “A Roadmap to Increased Patient Engagement at CMMI” to serve as a reference for engagement practices. In reviewing CMMI’s engagement strategies, we found that a number of its programs featured limited stakeholder involvement and transparency.  A core concern of ours is that the agency has not developed criteria for patient-centeredness nor an infrastructure for patient engagement, leading to significant concerns about the leap to mandatory models.  On the contrary, we believe that the establishment of meaningful criteria would provide a structured patient-focused framework to guide the agency’s work.  Patients should be engaged in developing patient-centeredness criteria and ensuring they are applied to the work of the Innovations Center.  As specified in statute, demonstrations should be evaluated against these criteria. By doing so, CMMI can build an infrastructure for patient engagement that goes beyond a mere notice and comment period and instead incorporates real mechanisms for achieving care that patients value. 
 
In order to align with care that patients value, it is imperative that alternative payment models incorporate high-quality decision aids to mitigate the potential for driving “one-size-fits-all” care.  Patient groups are prioritizing the development of shared decision-making tools, informed by their work to identify and reach patients from whom we can learn about the real-world impact of treatments. And patients need the ability to make informed choices about their care so that we are not wasting health care resources on treatments that don’t achieve what the patient wants.  While the program for shared decision-making in accountable care organizations currently underway at CMMI is a good start, the agency should develop standards for shared decision-making that assure their implementation in a manner that is transparent, understandable to patients, and broadly disseminated for use.  High quality shared decision-making should be a core component of all new models going forward.
 
By contrast, policies that seek to standardize care in a manner that has the potential to limit patient access to care that is suited to their needs, preferences and outcomes only serve to hinder the promise of personalized medicine. Medicare beneficiaries are not a homogenous population. Patients have varying levels of functionality; some continue to be runners or play sports, while others may be less active. Therefore, it is vital that the device or treatment chosen for each beneficiary be appropriately suited to their personal needs, preferences and outcomes. It is also imperative that patients in alternative payment models or other demonstrations are provided access to protections, such as a rapid appeals process or access to an ombudsman, that would allow for a more individualized approach to their care.
 
Engaging the patient community is a complex task that requires more than the notice and comment processes traditionally used by regulatory agencies. However, a more structured process for patient engagement that leverages CMMI’s own best practices, along with creative methods employed by organizations such as the Patient-Centered Outcomes Research Institute (PCORI) and the Food and Drug Administration’s Patient Focused Drug Development Initiative, will ensure that the patient perspective is well represented in CMMI’s model tests and improve their likelihood of success.
 
With patient engagement, we look forward to the introduction of new models with support and buy-in from the impacted patient communities that will be integral to their success.

Comments are closed.

    Topics

    All
    Alternative Payment Models
    Chairman's Corner
    Patient Centered Research
    PIPC In The News
    PIPC Patient Blog
    PIPC Weekly Update
    Press Releases
    The Data Mine
    Value Frameworks

    Archives

    January 2023
    December 2022
    November 2022
    October 2022
    September 2022
    August 2022
    July 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    January 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    August 2013
    July 2013
    June 2013
    April 2013
    March 2013
    December 2012
    November 2012
    February 2012
    September 2011
    August 2011
    July 2011
    May 2011
    March 2011
    November 2010
    October 2010
    September 2010
    August 2010
    April 2010
    March 2010
    February 2010
    December 2009
    September 2009
    July 2009
    June 2009
    May 2009
    February 2009
    January 2009
    December 2008

About PIPC
The Issues
Resources
Blog
In the News
Press Releases
Contact Us
100 M Street, SE – Ste. 750
Washington, DC 20003