In This Week’s Issue:
1. PIPC Responds to HHS Announcement on Medicare and Value-Driven Care, click here to view the statement.
2. E&C Releases 21st Century Cures Draft; Senate HELP Releases Analogous Report on Medical Innovation,click here and here for details.
3. Precision Medicine Initiative, click here to view.
4. Health Care Transformation Task Force Improving Commercial, Medicaid and Medicare Accountable Care Organizations, click here to view the full document.
5. WSJ: What is Government’s Role in Comparing Medical Treatments? Click here to view the blog.
6. PCORI: Funding Research on How Best to Communicate and Disseminate Research Findings, click here to view the full blog.
7. PCORI Board Approves New Advisory Panel and New PCORnet Demonstration Project, click here to view the full release.
8. Nominations Open for Members of the New England Comparative Effectiveness Public Advisory Council (CEPAC), click here for more information and to apply before February 23.
9. Medical Journal Articles, see below for details.
10. AHRQ Effective Program Updates, see below for details.
1. PIPC Responds to HHS Announcement on Medicare and Value-Driven Care, click here to view the statement.
2. E&C Releases 21st Century Cures Draft; Senate HELP Releases Analogous Report on Medical Innovation,click here and here for details.
3. Precision Medicine Initiative, click here to view.
4. Health Care Transformation Task Force Improving Commercial, Medicaid and Medicare Accountable Care Organizations, click here to view the full document.
5. WSJ: What is Government’s Role in Comparing Medical Treatments? Click here to view the blog.
6. PCORI: Funding Research on How Best to Communicate and Disseminate Research Findings, click here to view the full blog.
7. PCORI Board Approves New Advisory Panel and New PCORnet Demonstration Project, click here to view the full release.
8. Nominations Open for Members of the New England Comparative Effectiveness Public Advisory Council (CEPAC), click here for more information and to apply before February 23.
9. Medical Journal Articles, see below for details.
10. AHRQ Effective Program Updates, see below for details.
1. PIPC Responds to HHS Announcement on Medicare and Value-Driven Care
Last Monday, Health and Human Services (HHS) Secretary Sylvia Burwell announced new goals intended to move the Medicare program further toward value-driven health care. In addition, Secretary Burwell unveiled a newly launched Health Care Payment Learning and Action Network to support those goals. HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018. HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs. This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.” Read the full press release here.
In response to these announcements, PIPC Chairman Tony Coelho released the following statement: “PIPC shares the Secretary’s goal of achieving a more efficient, high-quality and patient-centered health care system. Since its founding, PIPC has been at the forefront of patient-centeredness in comparative effectiveness research (CER) – both its generation at the Patient-Centered Outcomes Research Institute (PCORI) and translation into patient care. Having driven the concept of patient-centeredness in the conduct of research, PIPC looks forward to also bringing the patient voice to the discussion of how to advance patient-centered principles in an evolving health care system. We recognize that policymakers want to shift from health care payment based on volume to “value-based” models.
Chairman Coelho continued, "As the Secretary seeks to develop and test new payment models for specialty care, starting with oncology care, and institute payments to providers for care coordination for patients with chronic conditions, we also urge consideration of the significant implications these models will have on the patient-centeredness movement, and the related issues of patient access and the physician-patient relationship. As part of our ongoing commitment to patient-centeredness in health care, PIPC recently developed a white paper to highlight some of the most important opportunities and issues that must be addressed in translating principles of patient-centeredness into value-based payment. It will be imperative for the newly created Network to include the patient voice so that value for the patient is prioritized." Click here to view the statement.
Further, as an article in the New England Journal of Medicine article points out, HHS intends to focus on three primary strategies to deliver on these value-based payment goals:
2. E&C Releases 21st Century Cures Draft; Senate HELP Releases Analogous Report on Medical Innovation
On Tuesday, characterizing it as a “starting point” for enacted legislation by the year-end, the House Energy and Commerce Committee just released a discussion draft of its highly anticipated 21st Century Cures bill. The draft follows a nearly yearlong process of gathering stakeholder input through hearings, white papers and comment opportunities, with Chairman Fred Upton (R-MI) noting that a policy’s inclusion in the draft does not necessarily signal endorsement and that the Committee “looks forward to continuing to work with both Republicans and Democrats on ideas to provide additional resources, including to the National Institutes of Health.” Rep. Upton – who spearheaded the initiative with Rep. Diana DeGette (D-CO) – adds that “[s]ome ideas may be added while other ideas may be dropped as the discussion moves forward, creating an improved final product shaped by this open and transparent process.” The draft includes a provision on patient-focused drug development which states, "Because no one understands a particular condition or disease better than patients living with it, FDA would be required to establish a structured framework for the meaningful incorporation of patient experience data into the regulatory decision-making process, including the assessment of desired benefits and tolerable risks associated with new treatments.” The Committee requests stakeholder input. Click here to view a summary of the legislation.
Also last week, Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) and Sen. Richard Burr (R-NC) released a report similarly addressing drug and device discovery, Food and Drug Administration (FDA) review processes and National Institutes of Health (NIH) investment. The Senate HELP report initiates a process drawing on the House E&C’s year-old 21st Century Cures, with Sens. Alexander and Burr anticipating working with Ranking Member Patty Murray (D-WA) on a bipartisan working group and series of hearings that will “examine the time and cost currently involved with the drug and medical device discovery and development process, and how to better align public policies to support medical innovation.” Like E&C, it explicitly targets passage of legislation by the year-end, although the Senate report is not yet at the stage of presenting specific policies for consideration. The Senate HELP Committee has requested stakeholder input by February 23, 2015. Click here to view the press release.
3. Precision Medicine Initiative
The Administration is unveiling details about the Precision Medicine Initiative, launched with a $215 million investment in the President’s 2016 Budget. The White House states, "Most medical treatments have been designed for the 'average patient.' As a result of this 'one-size-fits-all-approach,' treatments can be very successful for some patients but not for others...Precision medicine gives clinicians tools to better understand the complex mechanisms underlying a patient’s health, disease, or condition, and to better predict which treatments will be most effective.” The initiative would provide $130 million to NIH to develop a voluntary national research cohort, $70 million to the National Cancer Institute (NCI), $10 million to FDA, and $5 million to the Office of the National Coordinator for Health Information Technology (ONC). Click here to view the summary.
4. Health Care Transformation Task Force Improving Commercial, Medicaid and Medicare Accountable Care Organizations
The Health Care Transformation Task Force, an industry consortium of patients, payers, providers and purchasers, released a proposal on Thursday regarding value-based payments models. According to a statement, the Task Force “is dedicated to accelerating the transformation of the U.S. health care system to value-based business and clinical models aligned with improving outcomes and lowering costs. To that end, the Task Force developed principles that are important components of successful accountable care payment arrangements and delivery models, and necessary to expanding ACOs beyond their current footprint.” Click here to view the full document.
5. WSJ: What is Government’s Role in Comparing Medical Treatments?
A blog by Chris Jacobs from America Next in the Wall Street Journal states, "The personalized medicine initiative that President Barack Obama announced on Friday was previewed in the State of the Union address and is scheduled for inclusion in the budget to be released Monday. But in devoting federal funds to this, the administration may have made an argument against another type of medical research funded as part of Obamacare.” After describing PCORI’s responsiveness to personalized medicine, Mr. Jacobs concludes, "The president’s new initiative may make such research obsolete. It also raises a different question: When personalized medicine may turn patient ‘groups' into a subpopulation of one, what is the proper role for the federal government in comparing treatments?” Click here to view the blog.
6. PCORI: Funding Research on How Best to Communicate and Disseminate Research Findings
Last Thursday, Christopher Gayer and Bridget Gaglio, two Science Program Officers at PCORI, teamed up with Chief Engagement and Dissemination Officer Jean R. Slutsky for a post in the PCORI Blog. “Clear communication and active dissemination of research findings are critical to seeing that patients and others in the healthcare community are aware of, and can make use of, needed evidence. Yet, the healthcare community needs to know more about how to optimally communicate findings and facilitate use of new evidence and tools. In response, PCORI's Communication and Dissemination Research (CDR) program is tackling this issue head on by funding research on the comparative effectiveness of different strategies for communicating and disseminating health information.” Click here to view the post.
7. PCORI Board Approves New Advisory Panel and New PCORnet Demonstration Project
According to a recent press release, “The Patient-Centered Outcomes Research Institute (PCORI) Board of Governors today approved the charter for a new Advisory Panel on Communication and Dissemination Research (CDR). The Board also approved the commitment of up to $9 million to fund a pair of obesity-related demonstration studies testing the resources of PCORnet, the National Patient-Centered Clinical Research Network.” Click here to view the full release.
BioCentury also reported on PCORI last week, “The Patient-Centered Outcomes Research Institute is seeking members for a new advisory panel on communication and dissemination research, which will provide guidance to PCORI and help identify topics for possible funding. PCORI is targeting 12-21 members, with at least one-quarter being patients, caregivers, or representatives of patient advocacy organizations...PCORI also said it will provide $9 million to fund two observational obesity studies that will test the technical resources of PCORnet[…]” Click here to view the full article.
8. Nominations Open for Members of the New England Comparative Effectiveness Public Advisory Council (CEPAC)
The Institute for Clinical and Economic Review is seeking nominations of clinicians as well as patient and public representatives to serve on the New England Comparative Effectiveness Public Advisory Council. “CEPAC is a regional body that provides objective, independent guidance on the application of medical evidence to clinical practice and payer policy decisions across New England. Supported by a consortium of New England state health policy leaders, provider groups, and payers, CEPAC holds public meetings to consider evidence reviews of medical tests, treatments, and models for health care delivery, and to provide judgments regarding how the evidence can best be used across New England to improve the quality and value of health care services. New council members will be elected to serve for a three-year term, during which they will attend two full-day meetings per year. No council member is able to serve more than two consecutive three-year terms, though after a one-year absence, former council members are eligible to serve on CEPAC again.” Click here for more information and to apply before February 23.
9. Medical Journal Articles
The Role of Patient Activation in Achieving Better Outcomes and Cost-Effectiveness in Patient Care: Click here to view.
Nonsteroidal Anti-Inflammatory Drugs and the Risk for Anastomotic Failure: A Report From Washington State's Surgical Care and Outcomes Assessment Program (SCOAP): Click here to view.
Comparative Effectiveness of Intravitreal Bevacizumab With or Without Triamcinolone Acetonide for Treatment of Diabetic Macular Edema: Click here to view.
RELM: Developing a Serious Game to Teach Evidence-Based Medicine in an Academic Health Sciences Setting: Clickhere to view.
10. AHRQ Effective Program Updates
Diabetes Medications for Adults with Type 2 Diabetes: An Update Focused on Monotherapy and Add-on Therapy to Metformin: Click here to view the research protocol.
Last Monday, Health and Human Services (HHS) Secretary Sylvia Burwell announced new goals intended to move the Medicare program further toward value-driven health care. In addition, Secretary Burwell unveiled a newly launched Health Care Payment Learning and Action Network to support those goals. HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018. HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs. This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.” Read the full press release here.
In response to these announcements, PIPC Chairman Tony Coelho released the following statement: “PIPC shares the Secretary’s goal of achieving a more efficient, high-quality and patient-centered health care system. Since its founding, PIPC has been at the forefront of patient-centeredness in comparative effectiveness research (CER) – both its generation at the Patient-Centered Outcomes Research Institute (PCORI) and translation into patient care. Having driven the concept of patient-centeredness in the conduct of research, PIPC looks forward to also bringing the patient voice to the discussion of how to advance patient-centered principles in an evolving health care system. We recognize that policymakers want to shift from health care payment based on volume to “value-based” models.
Chairman Coelho continued, "As the Secretary seeks to develop and test new payment models for specialty care, starting with oncology care, and institute payments to providers for care coordination for patients with chronic conditions, we also urge consideration of the significant implications these models will have on the patient-centeredness movement, and the related issues of patient access and the physician-patient relationship. As part of our ongoing commitment to patient-centeredness in health care, PIPC recently developed a white paper to highlight some of the most important opportunities and issues that must be addressed in translating principles of patient-centeredness into value-based payment. It will be imperative for the newly created Network to include the patient voice so that value for the patient is prioritized." Click here to view the statement.
Further, as an article in the New England Journal of Medicine article points out, HHS intends to focus on three primary strategies to deliver on these value-based payment goals:
- Create an environment in which hospitals, physicians, and other providers are rewarded for delivering high-quality health care and have the resources and flexibility they need to do so. In that regard, HHS notes that it intends to “develop and test new payment models for specialty care, starting with oncology care, and institute payments to providers for care coordination for patients with chronic conditions;”
- Improve the way care is delivered to buttress ongoing reforms, such as the Partnership for Patients initiative, Transforming Clinical Practice Initiative (TCPI), Medicaid health homes and patient-centered medical homes (PCMHs), among other efforts; and
- Accelerate the availability of information to guide decision making, noting “[o]ngoing efforts [to] advance interoperability through the alignment of health IT standards and practices with payment policy so that patients’ records are available when needed at the point of care to permit informed clinical decisions to be made in a timely fashion,” as well as further transparency-related work. HHS also notes the current role of the Patient-Centered Outcomes Research Institute (PCORI) and its expectations to disseminate PCORI’s research findings via electronic health records (EHRs) and other vehicles.
2. E&C Releases 21st Century Cures Draft; Senate HELP Releases Analogous Report on Medical Innovation
On Tuesday, characterizing it as a “starting point” for enacted legislation by the year-end, the House Energy and Commerce Committee just released a discussion draft of its highly anticipated 21st Century Cures bill. The draft follows a nearly yearlong process of gathering stakeholder input through hearings, white papers and comment opportunities, with Chairman Fred Upton (R-MI) noting that a policy’s inclusion in the draft does not necessarily signal endorsement and that the Committee “looks forward to continuing to work with both Republicans and Democrats on ideas to provide additional resources, including to the National Institutes of Health.” Rep. Upton – who spearheaded the initiative with Rep. Diana DeGette (D-CO) – adds that “[s]ome ideas may be added while other ideas may be dropped as the discussion moves forward, creating an improved final product shaped by this open and transparent process.” The draft includes a provision on patient-focused drug development which states, "Because no one understands a particular condition or disease better than patients living with it, FDA would be required to establish a structured framework for the meaningful incorporation of patient experience data into the regulatory decision-making process, including the assessment of desired benefits and tolerable risks associated with new treatments.” The Committee requests stakeholder input. Click here to view a summary of the legislation.
Also last week, Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) and Sen. Richard Burr (R-NC) released a report similarly addressing drug and device discovery, Food and Drug Administration (FDA) review processes and National Institutes of Health (NIH) investment. The Senate HELP report initiates a process drawing on the House E&C’s year-old 21st Century Cures, with Sens. Alexander and Burr anticipating working with Ranking Member Patty Murray (D-WA) on a bipartisan working group and series of hearings that will “examine the time and cost currently involved with the drug and medical device discovery and development process, and how to better align public policies to support medical innovation.” Like E&C, it explicitly targets passage of legislation by the year-end, although the Senate report is not yet at the stage of presenting specific policies for consideration. The Senate HELP Committee has requested stakeholder input by February 23, 2015. Click here to view the press release.
3. Precision Medicine Initiative
The Administration is unveiling details about the Precision Medicine Initiative, launched with a $215 million investment in the President’s 2016 Budget. The White House states, "Most medical treatments have been designed for the 'average patient.' As a result of this 'one-size-fits-all-approach,' treatments can be very successful for some patients but not for others...Precision medicine gives clinicians tools to better understand the complex mechanisms underlying a patient’s health, disease, or condition, and to better predict which treatments will be most effective.” The initiative would provide $130 million to NIH to develop a voluntary national research cohort, $70 million to the National Cancer Institute (NCI), $10 million to FDA, and $5 million to the Office of the National Coordinator for Health Information Technology (ONC). Click here to view the summary.
4. Health Care Transformation Task Force Improving Commercial, Medicaid and Medicare Accountable Care Organizations
The Health Care Transformation Task Force, an industry consortium of patients, payers, providers and purchasers, released a proposal on Thursday regarding value-based payments models. According to a statement, the Task Force “is dedicated to accelerating the transformation of the U.S. health care system to value-based business and clinical models aligned with improving outcomes and lowering costs. To that end, the Task Force developed principles that are important components of successful accountable care payment arrangements and delivery models, and necessary to expanding ACOs beyond their current footprint.” Click here to view the full document.
5. WSJ: What is Government’s Role in Comparing Medical Treatments?
A blog by Chris Jacobs from America Next in the Wall Street Journal states, "The personalized medicine initiative that President Barack Obama announced on Friday was previewed in the State of the Union address and is scheduled for inclusion in the budget to be released Monday. But in devoting federal funds to this, the administration may have made an argument against another type of medical research funded as part of Obamacare.” After describing PCORI’s responsiveness to personalized medicine, Mr. Jacobs concludes, "The president’s new initiative may make such research obsolete. It also raises a different question: When personalized medicine may turn patient ‘groups' into a subpopulation of one, what is the proper role for the federal government in comparing treatments?” Click here to view the blog.
6. PCORI: Funding Research on How Best to Communicate and Disseminate Research Findings
Last Thursday, Christopher Gayer and Bridget Gaglio, two Science Program Officers at PCORI, teamed up with Chief Engagement and Dissemination Officer Jean R. Slutsky for a post in the PCORI Blog. “Clear communication and active dissemination of research findings are critical to seeing that patients and others in the healthcare community are aware of, and can make use of, needed evidence. Yet, the healthcare community needs to know more about how to optimally communicate findings and facilitate use of new evidence and tools. In response, PCORI's Communication and Dissemination Research (CDR) program is tackling this issue head on by funding research on the comparative effectiveness of different strategies for communicating and disseminating health information.” Click here to view the post.
7. PCORI Board Approves New Advisory Panel and New PCORnet Demonstration Project
According to a recent press release, “The Patient-Centered Outcomes Research Institute (PCORI) Board of Governors today approved the charter for a new Advisory Panel on Communication and Dissemination Research (CDR). The Board also approved the commitment of up to $9 million to fund a pair of obesity-related demonstration studies testing the resources of PCORnet, the National Patient-Centered Clinical Research Network.” Click here to view the full release.
BioCentury also reported on PCORI last week, “The Patient-Centered Outcomes Research Institute is seeking members for a new advisory panel on communication and dissemination research, which will provide guidance to PCORI and help identify topics for possible funding. PCORI is targeting 12-21 members, with at least one-quarter being patients, caregivers, or representatives of patient advocacy organizations...PCORI also said it will provide $9 million to fund two observational obesity studies that will test the technical resources of PCORnet[…]” Click here to view the full article.
8. Nominations Open for Members of the New England Comparative Effectiveness Public Advisory Council (CEPAC)
The Institute for Clinical and Economic Review is seeking nominations of clinicians as well as patient and public representatives to serve on the New England Comparative Effectiveness Public Advisory Council. “CEPAC is a regional body that provides objective, independent guidance on the application of medical evidence to clinical practice and payer policy decisions across New England. Supported by a consortium of New England state health policy leaders, provider groups, and payers, CEPAC holds public meetings to consider evidence reviews of medical tests, treatments, and models for health care delivery, and to provide judgments regarding how the evidence can best be used across New England to improve the quality and value of health care services. New council members will be elected to serve for a three-year term, during which they will attend two full-day meetings per year. No council member is able to serve more than two consecutive three-year terms, though after a one-year absence, former council members are eligible to serve on CEPAC again.” Click here for more information and to apply before February 23.
9. Medical Journal Articles
The Role of Patient Activation in Achieving Better Outcomes and Cost-Effectiveness in Patient Care: Click here to view.
Nonsteroidal Anti-Inflammatory Drugs and the Risk for Anastomotic Failure: A Report From Washington State's Surgical Care and Outcomes Assessment Program (SCOAP): Click here to view.
Comparative Effectiveness of Intravitreal Bevacizumab With or Without Triamcinolone Acetonide for Treatment of Diabetic Macular Edema: Click here to view.
RELM: Developing a Serious Game to Teach Evidence-Based Medicine in an Academic Health Sciences Setting: Clickhere to view.
10. AHRQ Effective Program Updates
Diabetes Medications for Adults with Type 2 Diabetes: An Update Focused on Monotherapy and Add-on Therapy to Metformin: Click here to view the research protocol.