1. Tell Congress: Don't Let Medicare Get Between Patients and Their Doctors, click here to send a letter to your Member of Congress.
2. PIPC Poll: Americans Support Patient-Centered Solutions, Oppose Government Determining Value, click here to view the full survey results.
3. The New Era of Informed Consent: Getting to a Reasonable-Patient Standard Through Shared Decision Making, click here to view the article.
4. Designing Successful Bundled Payment Initiatives, click here to view the blog post.
5. When Effectiveness Wins, Everyone Wins: The Mission and Impact of PCORI, click here to view the article.
On March 8, 2016, the Center for Medicare and Medicaid Services (CMS) proposed a new Part B Drug Payment Model undermining ACA protections for patients and people with disabilities. 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 and contrary to public support for policies that allow doctors and patients to decide the best course of treatment without government interference (click here to view our poll).
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 input from patients and people with disabilities. PIPC urges patients, people with disabilities and their organizations to weigh in with Congress and with CMS to oppose one-size-fits-all policies in Medicare. Click here to contact your Member of Congress!
The approach CMS has taken in the proposed rule would represent a major step back for patients and people with disabilities. Therefore, PIPC and the American Association of People with Disabilities (AAPD) welcome other organizations to sign onto our formal comments (view here) on the proposed rule urging CMS not to move forward with its proposal. Instead, we hope to continue working with the agency and other stakeholders to ensure that, as it seeks to advance value-based health care, it is supporting care valued by patients and people with disabilities. Contact firstname.lastname@example.org to sign on before the deadline on May 9, 2016.
Additional background on the proposed rule is available here.
2. PIPC Poll: Americans Support Patient-Centered Solutions, Oppose Government Determining Value
The Partnership to Improve Patient Care (PIPC)—whose members include organizations representing patients, people with disabilities and other stakeholders—reecently released a public opinion poll regarding healthcare delivery and access in America. The survey, which builds on prior surveys conducted by PIPC in 2013 and 2015, shows that of nearly 2,000 registered voters polled by Morning Consult, 8 in 10 say that doctors and patients should be able to decide the best course of treatment without government interference and that Medicare reforms should move toward patient-centered health care by giving physicians and patients the support they need to choose the best care for them.
This survey follows the Centers for Medicare & Medicaid Services’ (CMS) recently proposed new Part B Drug Payment Model, calling for government-determined centralized value determinations based upon comparative effectiveness and cost-effectiveness analyses. Consistent with the poll’s findings, PIPC is strongly opposed to putting CMS in the position of deciding value on behalf of patients, which would create substantial new barriers to patient access, and undermine the movement toward patient-centered healthcare. Indeed, the survey finds that 7 in 10 voters oppose allowing CMS to determine what is valuable for patients based on an average.
The survey demonstrates that voters resoundingly reject the main tenets of the CMS proposal.
Additional key findings include:
- 9 in 10 voters agree that health care decisions should be made between doctors and patients
- 6 in 10 voters oppose government efforts to set national protocols for medical care to promote mindful prescribing by physicians for Medicare patients
- 2 in 3 voters do not think the government should try to save money by setting preferred courses of treatment for diseases
- More than 6 in 10 voters oppose government deciding when drugs are similar on average in order to give prescribers incentives to use certain drugs
- Finally, 86 percent of voters think it is important to maintain the current Medicare safeguard that prohibits the government from using cost-effectiveness in making coverage or payment decisions because it may discriminate against seniors and people with disabilities.
PIPC Chairman Tony Coelho stated, “This survey highlights the importance of PIPC’s long-standing efforts to support patient-centered approaches to comparative effectiveness research and payment and delivery reform, and strong concern with the one-size-fits-all approach taken by the Centers for Medicare and Medicaid Services (CMS) in its March 8 proposed rule. PIPC has worked too hard and too long to give patients a meaningful voice in health care decisions to go back to sidelining patients in their own care decisions; we urge CMS to withdraw this proposed rule and instead embrace solutions that will put patients at the center of value.” Click here to view the full survey results.
3. The New Era of Informed Consent: Getting to a Reasonable-Patient Standard Through Shared Decision Making
A leading group of researchers commented last week in the Journal of the American Medical Association (JAMA), “Expanded policy efforts are needed, such as those taking place in Washington State, that embrace shared decision making with the use of certified patient decision aids as an acceptable and preferred standard for informed consent... Value-based payment models that recognize high-quality informed consent practices need to be implemented and studied.” Click here to view the article.
4. Health Affairs Blog: Designing Successful Bundled Payment Initiatives
As Michael Ciarametaro and Robert Dubois commented last week on Health Affairs Blog, “Successful bundled payment programs will 1) begin with mostly homogeneous patient populations and well-defined quality metrics and expand to other areas as better risk adjustment and quality metrics become available; 2) put protections in place to safeguard the most vulnerable stakeholder, the patient; and, 3) place an emphasis on aligning physician incentives with the patients' best interest.” Click here to view the blog post.
5. When Effectiveness Wins, Everyone Wins: The Mission and Impact of PCORI
In an interview with The Hematologist, PCORI Executive Director Dr. Joe V. Selby comments on the mission and impact of PCORI. “[Caregivers, patient organizations, clinical specialty organizations, payers, and employers] help ensure that PCORI identifies the right questions, studies them in appropriate ways, interprets the data in light of all the available information, and disseminates and implements the findings widely when studies suggest that practice should change. ‘We're seeing that when patients and other stakeholders partner with scientists in choosing research questions, as well as in designing and conducting studies to answer those questions, they make it more likely that the results will be relevant to them and incorporated into daily practice,’ says [PCORI Executive Director Dr. Joe V. Selby].” Click here to view the article.