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The PIPC Blog

PIPC Weekly Update - November 10, 2014

11/10/2014

 
n This Week’s Issue:
1. PIPC Comments on MedPAC Consideration of Least Costly Alternative (LCA) Policy, click here to view PIPC’s letter.
2. PIPC Member, NAMI, Comments to PCORI on Proposal for Peer Review of Primary Research and Public Release of Research Findings, click here to view the letter.
3. Brookings, RAND Release Report on APMs in Gastroenterology, click here to view the report.
4. CMS Seeks Nominations for MEDCAC, click here to view the notice.
5. Health Affairs: The Payment Reform Landscape: Benefit And Network Design Strategies To Complement Payment Reform, click here to view the blog.
6. Using Real-World Data for Outcomes Research, Comparative Effectiveness Studies, click here to view the article.
7. Modern Healthcare: Actor Alan Alda advises AAMC attendees on how to talk about medical science, click here to view the article.
8. Medical Journal Articles, see details below.
9. AHRQ Effective Program Updates, see details below.
1. PIPC Comments on MedPAC Consideration of Least Costly Alternative (LCA) Policy
On Friday, the Medicare Payment Advisory Commission (MedPAC) held discussion to explore “least costly alternative” judgments about patient treatment options.  PIPC released the following statement:  “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.”
“We already know that engaged and active patients are more compliant with their treatment protocol because they are given a meaningful role in defining the care that is best for them. Engaged patients fill prescriptions and take them, they make appointments with rehab specialists, and they go in for their follow-ups. We also know that meaningful patient engagement requires that they trust in the system and their care providers, embrace the principles of shared decision-making, and recognize the benefits of being activated.”
“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.”  To view PIPC’s recent letter to MedPAC, click here.

​2. PIPC Member, NAMI, Comments to PCORI on Proposal for Peer Review of Primary Research and Public Release of Research Findings

On Friday, the National Alliance for Mental Ilness (NAMI)—a PIPC member—submitted comments to PCORI on proposed guidelines for peer review of research findings.  “As a patient advocacy organization, NAMI supports the work of PCORI to undertake patient-centered comparative effectiveness research that can better inform clinical care decision-making.  NAMI is especially supportive of the efforts that the PCORI board and staff have made over the past few years to ensure meaningful patient engagement that drives the development of research priorities, the review of research findings and dissemination of results… NAMI supports the careful balance that PCORI has achieved with these standards for peer review.  In the end, this peer review process will be critical in ensuring that PCORI funded research has the integrity and credibility that will be needed to be useful for patients and their providers.” Click here to view the letter.

3. Brookings, RAND Release Report on APMs in Gastroenterology

Recently, the Brookings Institution and RAND released a report on alternative payment models in specialty care that focused on gastroenterology.  “Brookings Institution convened a technical expert panel (TEP) to solicit input on how best to design an alternative payment approach for gastroenterology specialty care. This TEP was part of the Specialty Physician Payment Model Opportunities Assessment and Design project, a Center for Medicare & Medicaid Innovation (CMMI) effort with the intent of identifying opportunities for better alignment of high quality care delivery and supporting payments in gastroenterology and additional specialties. The project aligns with CMMI’s goals of developing models that improve quality of care, reduce total costs of care, or both. CMMI’s objective is to create and evaluate models based on these two constraints and scale them nationally.”  Click here to view the report.

4. CMS Seeks Nominations for MEDCAC

The Centers for Medicare & Medicaid Services (CMS) is seeking nominations for the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC). MEDCAC “provides advice and guidance to the Secretary of the Department of Health and Human Services and the Administrator of the CMS concerning the adequacy of scientific evidence available to CMS in making coverage determinations under the Medicare program.” Specifically the Committee “reviews and evaluates medical literature and technology assessments, and hears public testimony on the evidence available to address the impact of medical items and services on health outcomes of Medicare beneficiaries.”
The MEDCAC is comprised of 100 appointed members including: 94 at-large standing members (six of whom are patient advocates), and six representatives of industry interests. In June 2015, 16 membership terms are expiring: two are industry representatives, one is a patient advocate, and the remaining 13 membership openings are for the at-large standing MEDCAC membership. The notice explains that members generally are recognized authorities in clinical medicine "including subspecialties, administrative medicine, public health, biological and physical sciences, epidemiology and biostatistics, clinical trial design, health care data management and analysis, patient advocacy, health care economics, medical ethics or other relevant professions."  Application details are included in the notice and nominations must be received by Monday, December 8, 2014.  Click here to view the notice.

5. Health Affairs: The Payment Reform Landscape: Benefit And Network Design Strategies To Complement Payment Reform

Suzanne Delbanco writes in Health Affairs Blog, “V-BID can help to differentiate between high-value and low-value providers, and between high-value and low-value services, adding in the element of medical necessity...V-BID also discourages them from seeking care not likely to improve their health. Coupling V-BID with care management fees, or shared savings or shared risk, is another ‘potent pair.’” Click here to view the blog.

​6. PCORI Blog: PCORI-Funded Partnerships Examine How Best to Support Caregivers
On Wednesday, Kristen Konopka, Courtney Clyatt, and Susan Sheridan of PCORI’s Engagement program wrote a post on The PCORI Blog highlighting a few of the PCORI-funded projects that focus on how to improve the support offered by caregivers.  “This year, we thought we'd share examples of a different approach to improving the lives of caregivers and the patients they support. Through our Pipeline to Proposal awards, we invest in projects that build capacity for patients, caregivers, researchers, and other healthcare stakeholders to build partnerships from the ground up around a common healthcare interest. Below we describe five Pipeline to Proposal awards that highlight caregivers.” Click here to view the blog.

7. Modern Healthcare: Actor Alan Alda advises AAMC attendees on how to talk about medical science
Actor Alan Alda spoke at the annual meeting of the Association of American Medical Colleges being held Nov. 7-11 in Chicago. According to the article, "The public is 'on a blind date' with science and medicine, said actor Alan Alda. The two sides don't know each other very well and they're still deciding whether they trust and feel safe with each other. That could be why patients demand to receive a non-existent Ebola vaccine but pass on getting a flu shot.”   Click here to view the article.

8. Medical Journal Articles
Comparing Traditional and Participatory Dissemination of a Shared Decision Making Intervention (ADAPT-NC): A Cluster Randomized Trial, click here to view.
Comment & Response: New EMA Policy—Further Measures Needed to Support Comparative Effectiveness Assessments, click here to view.
From Evidence-Based Medicine to Patient-Centered Medicine: Legal Medicine Considerations about Professional Responsibility, click here to view.
An Economic Model to Compare Linezolid and Vancomycin for the Treatment of Confirmed Methicillin-Resistant Staphylococcus Aureus Nosocomial Pneumonia in Germany, click here to view.
Ipilimumab Plus Sargramostim vs Ipilimumab Alone for Treatment of Metastatic Melanoma: A Randomized Clinical Trial, click here to view.
Vaccination of Children with a Live-Attenuated, Intranasal Influenza Vaccine - Analysis and Evaluation Through a Health Technology Assessment, click here to view.
What Can Comparative Effectiveness Research Contribute to Integrative Health in International Perspective?, click here to view.
Recentralizing Healthcare Through Evidence-Based Guidelines: Striving for National Equity in Sweden, click here to view.

9. AHRQ Effective Program Updates
Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis, click here to comment by December 2.
Diagnosis of Gout, click here to comment by December 2.
Management of Insomnia Disorder, click here to comment by December 2.
Management of Gout, click here to view the research protocol.
Antidepressant Treatment of Depression During Pregnancy and the Postpartum Period, click here to view the disposition of comments report.
Decision Aids for Advance Care Planning, click here to view the disposition of comments report.

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