In a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, Partnership to Improve Patient Care (PIPC) Chairman Tony Coelho criticized the HHS Notice of Benefit and Payment Parameters for focusing on cost effectiveness and creating a national default definition of essential health benefits. While the notice proposes flexibility for states in defining essential health benefits, Chairman Coelho noted that the Notice of Benefit does not focus on how to align payment with achieving care tailored to individual patients. "It fluctuates between a policy of “anything goes” by allowing states increased flexibility in defining their benefit packages, and a “one-size-fits-all” policy relying on cost effectiveness reports to determine patient access to care," wrote Chairman Coelho. "To truly put patients first, CMS should instead embrace this as an opportunity to change the culture of our payment system to be patient-centered."
In a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, Partnership to Improve Patient Care (PIPC) Chairman Tony Coelho submitted comments on behalf of PIPC in response to the Request for Information on a new direction to promote patient-centered care at the Center for Medicare and Medicaid Innovation (CMMI). Chairman Coelho urged CMS to implement "concrete reforms" in four key areas, including: (1) Defining a clear, consistent process for engaging patients and other stakeholders in development and implementation of CMMI evaluations; (2) Defining and adopting detailed criteria for patient-centeredness in CMMI evaluations; (3) Building on and strengthening the patient safeguards articulated in the RFI and; (4) Pursuing demonstrations that embody these reforms and put patients at the center of the health care.
In a letter to Department of Veterans Affairs Secretary David Shulkin, over 40 representatives of veterans, patients and people with disabilities expressed concern regarding the recently announced collaboration between the Institute for Clinical Economic Review (ICER) and the Department of Veterans Affairs (VA) Pharmacy Benefits Management Services office. They cautioned Secretary Shulkin about ICER's quality-adjusted-life-year (QALY) metric, citing its "potentially discriminatory" impact on people with disabilities and serious chronic conditions.