Poll of 2,001 registered voters finds most Americans want to decide the best course of treatment with their doctors and oppose government use of cost-effectiveness assessments Today, the Partnership to Improve Patient Care (PIPC) released a public opinion poll by Morning Consult regarding the use of cost-effectiveness assessments to determine value of coverage and treatment costs. The survey demonstrates that voters resoundingly reject the main tenets of cost-effectiveness analyses with 82 percent of American voters objecting to their use in determining health care coverage and reimbursement decisions. These types of measures, which are often used outside of the U.S. to limit patient access to medicines, have been frequently criticized as discriminatory by patients and persons with disabilities. Increasingly, policymakers and payers have proposed to use these same tools to limit coverage for Medicare and Medicaid beneficiaries.
As Chairman of the Partnership to Improve Patient Care (PIPC), I have seen tremendous progress in the patient-centeredness movement, particularly in changing the culture of medical research. Yet, our leaders should know that we still have a long way to go to give patients, people with disabilities, veterans and caregivers a voice in how we deliver care that patients value. They deserve a seat at the table in any discussion of health care policy, as well as meaningful opportunities to voice their unique and real experiences On April 19, 2017, I provided comments to the Centers for Medicare and Medicaid Innovation (CMMI) on behalf of the Partnership to Improve Patient Care (PIPC) related to some new, recently proposed episode payment models. I applauded the agency for making a deliberate and conscious effort to solicit authentic patient feedback about their proposed new payment models. Although I’ve been critical in the past, I told them that I appreciated their seizing of this opportunity to forge a new path forward on engaging stakeholders, particularly patients, in the development, implementation and evaluation of alternative payment models. The Washington Post: PIPC's Tony Coelho Discusses Need for Change in Medicare's Innovation Center12/13/2016
In response to Washington Post opinion article, "Keep this part of Obamacare," PIPC Chairman Tony Coelho emphasizes the fact that while the Center for Medicare and Medicaid Innovation (CMMI) appears to be doing "some good work," it is also in serious need of changes to protect patients. "The Innovation Center created significant (if unintended) risks with some models that patients identified as going too far and driving “one-size-fits-all” care in stark contradiction of the nation’s drive to develop targeted therapies under the Precision Medicine Initiative and Cancer Moonshot," Coelho writes. "We all want health care to pay for value and not volume, but the real question is value for whom?" What's the most important question facing any patient with a life-threatening illness? "Which treatment option is best for me?" By most accounts, this is a good problem to have; giving patients a range of treatment options, and the ability to make an informed choice about the regimen that most directly aligns with their personal health priorities is fundamental to high-quality, individualized health care. But along with these new methods for treatment come difficult questions. Do I want the more aggressive or conservative therapy? Is my quality of life during treatment more important than returning to work quickly? Which course of action has more tolerable side effects? Can I afford the care I need? What's the most important question facing any patient with a life-threatening illness?
"Which treatment option is best for me?" By most accounts, this is a good problem to have; giving patients a range of treatment options, and the ability to make an informed choice about the regimen that most directly aligns with their personal health priorities is fundamental to high-quality, individualized health care. But along with these new methods for treatment come difficult questions. Do I want the more aggressive or conservative therapy? Is my quality of life during treatment more important than returning to work quickly? Which course of action has more tolerable side effects? Can I afford the care I need? On Friday, the Partnership to Improve Patient Care (PIPC) hosted a webinar featuring Avalere Health and PIPC to discuss the development, implementation and evaluation of alternative payment models (APMs). With increased authority to test new approaches to health care - and potentially expand successful models throughout federal health programs - patients must be aware and engaged to ensure that the Centers for Medicare and Medicaid Innovation (CMMI) measures success of APMs based on value to the patient. The webinar offered an opportunity for patients and patient organizations to learn more about APMs and the implications a transition to APMs will have for patient-centered care.
Many people want to quantify “value” in health care. But for the ultimate beneficiary, the patient, value is more personal. That doesn’t mean we can’t get better value, it just requires us to find ways that respect patients and their diverse care needs and preferences. This was the big message I took away from a roundtable recently convened by the Partnership to Improve Patient Care (PIPC) and the Cancer Support Community (CSC) with many leading organizations representing cancer patients.
PIPC Chairman Tony Coelho recently wrote an op-ed for Morning Consult discussing the Partnership's recent oncology roundtable and arguing that value-based healthcare discussions need to include patient-centeredness. As Chairman Coelho concludes, "Our healthcare system will never know how to measure and reward quaity if we don't ask patients what they value. Patients are ready to move towards better value, but to get there, you need to put us in the driver's seat." The Partnership to Improve Patient Care (PIPC), along with nine leading patient and cancer care advocates, released a landmark set of recommendations reflecting the consensus of patient communities on how to outcomes that matter to oncology patients. The summary —based on a recent roundtable discussion convened by PIPC— outlines priorities for public policy in cancer care as the healthcare system shifts away from a fee-for-service (FFS) model to alternative payment models (APMs) that reward providers for their ability to achieve “value.”
In a recent column posted in Morning Consult, PIPC Chairman Tony Coelho writes about the conclusions drawn from the PIPC Roundtable Discussion held in June and what they mean for the future of patient engagement in alternative payment models (APMs). Chairman Coelho noted that the Roundtable Discussion highlighted a "remarkable consensus on commonsense, workable approaches that can ensure that the widespread adoption of alternative payment models will serve to empower patients and draw them towards the center of care delivery." The full column "Strategies to Engage and Empower the Patient in Care Delivery: Just Ask the Patient" can be found on the Morning Consult website. There’s a lot of talk right now about moving health care towards value-based payment models. But will these new models reward care that patients actually value? Maybe. It depends, first and foremost, on bringing patients into the conversation and giving them a meaningful voice.
The Affordable Care Act embraced important patient-centered principles, through the creation of the Patient-Centered Outcomes Research Institute (PCORI), and its embrace of concepts like shared decision-making in health care. The shift from a payment system based on quantity to quality could be promising – depending on how we define quality. But if the healthcare system of the future is to achieve outcomes that matter to patients, it must systematically engage patients in their own healthcare decision-making and in governance. Without this sustained commitment, the enterprise will too easily slip to one that merely rewards providers for achieving cost containment through fewer treatment or service choices for patients. When patient-centered outcomes research “is used well, it can be a powerful tool in making medical care better informed, without limiting patients’ and providers’ choices.” That was the promise that I, and many others, held out with creation of the Patient-Centered Outcomes Research Institute (PCORI) in 2010. Will PCORI achieve this goal? It is increasingly clear that evolving “value-based” payment models in health care, accelerated via the Affordable Care Act (ACA), will play a central role in how that question gets answered
Today, Health Affairs published an opinion piece written by Chairman Coelho to announce the release of PIPC's new White Paper on patient-centeredness in alternative payment models (APMs). Chairman Coelho wrote the op-ed to highlight the importance of building APMs on a foundation of patient-centeredness throughout the healthcare system. This White Paper and Health Affairs opinion represent an important step in PIPC’s discussion of the application of comparative effectiveness research, and should serve as an important tool for policymakers in considering the future of value-based payment models.
The Partnership to Improve Patient Care (PIPC) recognizes the importance of promoting health care delivery systems that support the related goals of patient-centeredness and medical progress through innovation and ongoing clinical research and analysis. It is from that premise that we came together to support the creation of the Patient-Centered Outcomes Research Institute (PCORI), and from which we advocate for patient-centeredness throughout our health system.
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