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The PIPC Blog

Inside Health Policy: 'Patient Groups Seek Key Role In Health Care Payment Learning And Action Network'

5/6/2015

 
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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. 

Patient Groups Seek Key Role In Health Care Payment Learning And Action Network
More than 60 patient groups and members of the Partnership to Improve Patient Care 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.

The groups, including Alliance for Aging Research, Association of Community Cancer Centers, United Spinal Association and many others, say that alternative payment models hold significant implications for patients and caregivers, and if patients are not put first, “the risk is that the initiative will define value in a 'one size fits all' manner that does not recognize differences among patients, potentially undermining the ability of patients and their providers to tailor care for the outcomes that they prefer and value.”

The groups say they are looking for a clear, supportive engagement plan for beneficiaries and people with disabilities in the initiative, the letter says.

CMS invited stakeholders across the industry to join the Health Care Payment Learning and Action Network to expand alternative payment models beyond Medicare and into Medicaid and the private sector in earlier this year. The network is part of HHS Secretary Sylvia Burwell's initiative that aims to tie 30 percent of fee-for-service Medicare payments to quality or value through alternative payment models like accountable care organizations or bundled payment arrangements by the end of 2016 and 50 percent by the end of 2018. National payment model goals within the Health Care Payment Learning and Action network must match or exceed what was set out for Medicare.

In late March, HHS said more than 40 organizations and states had come up with specific goals for alternative pay models and more than 2,800 patient groups, insurers, providers, consumer groups, payers and others registered to participate in the network.

“Organizations representing patients and people with disabilities could provide a unique and valuable voice, in addition to the voices of state representatives, insurers, providers, business leaders and consumers whose participation has already been solicited,” the patient groups' letter says. And at the heart of the network's goals should be aligning value-based payments and alternative payment models with patient-centeredness, the groups say.

FDA, with its Patient-Focused Drug Development Program, and PCORI created methods to actively solicit and support patient engagement, the letter says, and those methods could be modeled in HHS' initiative moving toward value-based payment. The groups urge HHS to build on these existing best practices and make it an explicit goal that the initiative be patient-centered.

“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.


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