1. PIPC Submits Comments to CMS on MACRA, Alternative Payment Models, click here to view the comments.
2. Save the Date: PIPC’s 6th Annual Forum on December 3rd, click here for details.
3. PIPC: Oncology Roundtable Summary and Recommendations, click here to view the summary.
4. LAN Seeks Feedback on APM Framework White Paper, click here to view the white paper.
5. NHMH Receives PCORI Award to Study Mental Health Delivery in Rural Communities, click here for details.
6. Forbes: Health Care Value Assessments Versus Patients and Progress, click here to view the article.
7. PCORI, AHA to Crowdsource Key Research for Cardiovascular Disease, click here to view the press release.
8. The Hill: America's Health System Can't Put Insurers Before Patients, click here to view the op-ed.
9. AP: Patients' Needs Addressed in 'Person-Centered Health Care', click here to view the article.
Last week, the Partnership to Improve Patient Care (PIPC) submitted comments on the implementation of the Merit-based Incentive Payment System (MIPS), Promotion of Alternative Payment Models, and Incentive Payments for Participation in Eligible Alternative Payment Models passed as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). PIPC states, "Per MACRA’s definition of an APM, the majority of APMs are likely to come out of the Center for Medicare and Medicaid Innovation (CMMI). As an overarching recommendation, we strongly recommend the creation of a Patient Advisory Panel by CMMI to help ensure new payment models are aligned with care that patients’ value. With so many issues to consider, we believe that creating a standing Patient Advisory Panel that is meaningfully connected to CMMI’s work is the single most important step that can be taken in the near term to achieve the goal of patient-centeredness in APMs."
The full comments submitted to the Centers for Medicare and Medicaid Services are available here.
2. Save the Date: PIPC’s 6th Annual Forum on December 3rd
On Thursday, December 3rd, the Partnership to Improve Patient Care (PIPC) will hold our 6th annual forum entitled, "CER in the Real World: The Value of Patient-Centered Outcomes Research." Does the term “patient-centered” sound familiar? Patient-centeredness begins with the development of evidence that patients can use to support improved health decision-making, often including a special type of comparative effectiveness research known now as patient-centered outcomes research. Policymakers, payers and advocates often use terms like patient-centeredness, patient engagement, and patient empowerment. Yet, just using the right terminology does not necessarily indicate a policy that achieves outcomes that matter to patients. Join PIPC for a discussion about the creation of the Patient-Centered Outcomes Research Institute and its implications for achieving outcomes that matter to patients. Click here for details, and email annika@PIPCpatients.org to RSVP.
3. PIPC: Oncology Roundtable Summary and Recommendations
The Partnership to Improve Patient Care (PIPC) and the Cancer Support Community (CSC) convened a roundtable on July 8, 2015 on “Patient-Driven Health Care and Evidence in Oncology: Setting an Agenda.” The roundtable participants represented patient organizations serving cancer patients, as well as a representative from the Patient-Centered Outcomes Research Institute (PCORI). Roundtable participants discussed the outcomes that matter to oncology patients and policies that would support high-quality, patient-driven cancer care.
As a result of the roundtable, the group developed consensus around a series of recommendations for policymakers, researchers and payers. The summary below refers to policymakers in the context of those working in federal government to influence health care policies, Members of Congress and their staff, agencies within the Department of Health and Human Services (HHS), particularly the Centers for Medicare and Medicaid Services (CMS), entities acting in an advisory capacity such as the National Quality Forum (NQF), and contractors hired to implement health care programs, particularly payers contracting with CMS as alternative payment models (APMs).
The roundtable served as a call to action for patient organizations to determine a guiding set of principles for the cancer patient communities that they represent, reflecting their priorities for public policy as the healthcare system shifts away from a fee-for-service (FFS) model to APMs that reward providers based on their ability to achieve “value.” It was agreed that the calculus used by some organizations to define “value” does not necessarily represent value to a patient. Therefore, it is vital for patients to come together around a core set of policy recommendations that will better achieve outcomes that matter to patients.
The full roundtable summary, including the policy recommendations advanced by the panel, is available here.
4. LAN Seeks Feedback on APM Framework White Paper
The Healthcare Payment Learning and Action Network’s (LAN) Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group is soliciting feedback on their APM Framework Draft White Paper by November 20, 2015. “The White Paper describes the approach that the work group used to develop the proposed APM Framework and delineates and describes principles upon which the APM Framework is based. With these principles in mind, the paper differentiates the categories within the APM Framework, by explaining how the categories are described, and where the boundaries between them lie. In order to further clarify the classification of individual APMs, case studies will be used to exemplify each of the categories and subcategories in the APM Framework, with a starting set included in the appendix. Information and positions taken in this document should be considered preliminary until the Work Group receives input from the LAN and releases a final version of the White Paper. Future iterations of the White Paper will include an Executive Summary and a conclusion that summarizes the Work Group’s key findings and implementation goals.” “[Stakeholder] comments will help to refine the final White Paper, which is targeted for release later this year. In particular, the work group is seeking feedback on:
the overall White Paper and proposed framework; descriptions associated with each category; the boundaries that differentiate one category from another; and additional examples and case studies you could provide to illustrate and test each category in the framework.The APM FPT Work Group will be collecting feedback:
online through a discussion forum on Handshake; and by email directly to PaymentNetwork@MITRE.org.Click here to view the white paper.
5. NHMH Receives PCORI Award to Study Mental Health Delivery in Rural Communities
Recently, the Patient Centered Outcomes Research Institute (PCORI) announced the award of a research contract to a new project called "Integrated Versus Referral Care for Complex Psychiatric Disorders in Rural FQHCs" (Federally Qualified Health Centers - i.e. safety net clinics) to No Health Without Mental Health (NHMH). The project will take place across three states (Washington, Michigan, Arkansas) involving over 1,000 patients at 15 primary care clinics. As described in a recent press release, “NHMH is proud to be part of this research project recognizing it has the potential to transform mental health care for an under-served, rural, minority, and veteran-populated community of patients. NHMH's participation will be as a member of the project's Consumer Advisory Board representing the patient perspective in how the project is designed, conducted and implemented. The project will study integrating psychiatric treatment of PTSD and bipolar disorders in rural primary care settings through two approaches -- tele-psychiatry collaborative care and tele-psychiatry enhanced referral care -- i.e. comparing both approaches for benefits as well as costs. The project addresses the important question of how to improve the treatment of two complex mental disorders (PTSD, bipolar) that frequently appear in primary care settings in rural areas, where access to specialty mental health care is very limited.” Click here to view details on the project.
6. Forbes: Health Care Value Assessments Versus Patients and Progress
In a recent article in Forbes, John Lechleiter comments that “research by the IMS Institute for Healthcare Informatics found a range of negative consequences, especially in cancer care, when it compared five countries that use [cost per QALY] approaches with five that don't. Patients in the five countries that use CPQ assessments have poorer access to new cancer drugs. And in the CPQ countries, ‘fewer new cancer drugs are reimbursed; reimbursement decisions take longer; new cancer drugs have historically been adopted more slowly and in the long term, at lower rates.’” Click here to view the article.
7. PCORI, AHA to Crowdsource Key Research for Cardiovascular Disease
The AHA and the Patient-Centered Outcomes Research Institute (PCORI) are launching a joint initiative that combines the outreach power of crowdsourcing with the lure of prizes to speed the identification of critical research needed to improve care for cardiovascular disease. In announcing the initiative, AHA Chief Executive Officer Nancy Brown said “the AHA and PCORI will capitalize on this unprecedented opportunity to address a critical challenge and accelerate research. We look forward to working with PCORI and communities interested in making a difference by identifying critical questions that can transform the research paradigm and set the stage for innovative comparative effective cardiovascular disease research.” The new program, the Precision Medicine Advances using Nationally Crowdsourced CER, or PRANCCER, will use crowdsourcing techniques to draw on the collective wisdom of millions of CVD patients, clinicians, family caregivers and researchers.
The initiative will seek input on critical gaps in the evidence about which CVD prevention, diagnostic and treatment approaches work best for which patients based on their needs and circumstances. Those are the types of questions that PCORI-funded comparative clinical effectiveness research, or CER, is designed to answer. It also will serve the AHA’s commitment to advancing precision cardiovascular medicine, which seeks to refine care for patients based on their particular characteristics. Cash prizes will be offered for the most scientifically rigorous and patient-centered research ideas. Click here to view the press release.
8. The Hill: America's Health System Can't Put Insurers Before Patients
In a recent op-ed published in The Hill, Dr. Kenneth Thorpe, Chairman of the Partnership to Fight Chronic Disease, comments, “a new report from the Institute for Clinical and Economic Review (ICER) concludes that PCSK9 inhibitors are overpriced...ICER's findings are part of a troubling trend in defining ‘value’ of new drugs and medical devices through the narrow lens of the insurer without considering broader benefits of better health...Even the so-called ‘comparative-effectiveness’ models used by the UK's controversial National Institute for Health and Care Excellence (NICE) -- an institution that explicitly rations care – are less reaching than ICER's budget-focused analysis, although not by much.” Click here to view the op-ed.
9. AP: Patients' Needs Addressed in 'Person-Centered Health Care'
According to a recent report from the Associated Press, “a poll of Americans age 40 and over conducted this year by The Associated Press-NORC Center for Public Affairs Research revealed some skepticism among those who have not tried this new kind of care. More than half of people receiving or providing care without a single health care manager, an aspect of person-centered care, didn't think their care would improve much if they had one, while more than three quarters of those who had one said it improved things a lot... The federal government is beginning to align payment with this kind of care, but critics including the American Health Care Association say much more is needed.” Click here to view the article.