In This Week’s Issue:
1. RSVP Now for the 8th Annual PIPC Forum! See details below.
2. PIPC Responds to HHS Notice of Benefit and Payment Parameters for 2019, click here to read the letter.
3. PIPC Submits Comments to CMS Regarding RFI on New Direction for CMMI, see details below
4. Letter to VA: Tell the VA to Rely on Veterans to Define Health Value - not QALYs! Click here to read the letter.
5. Letter to the Editor: We should move past stereotypes about older adults, click here to read the letter.
6. The PCORI Blog: Empowering COPD Patients to Better Manage Their Symptoms, Click here to read the blog.
7. PatientEngagementHIT: Do Patient-Centered Medical Homes Boost Chronic Care Management? Click here to read the article.
8. Upcoming Events and Webinars, see details below
9. Medical Journal Articles, see details below.
10. AHRQ Effective Program Updates, see details below
1. RSVP Now for the 8th Annual PIPC Forum! See details below.
2. PIPC Responds to HHS Notice of Benefit and Payment Parameters for 2019, click here to read the letter.
3. PIPC Submits Comments to CMS Regarding RFI on New Direction for CMMI, see details below
4. Letter to VA: Tell the VA to Rely on Veterans to Define Health Value - not QALYs! Click here to read the letter.
5. Letter to the Editor: We should move past stereotypes about older adults, click here to read the letter.
6. The PCORI Blog: Empowering COPD Patients to Better Manage Their Symptoms, Click here to read the blog.
7. PatientEngagementHIT: Do Patient-Centered Medical Homes Boost Chronic Care Management? Click here to read the article.
8. Upcoming Events and Webinars, see details below
9. Medical Journal Articles, see details below.
10. AHRQ Effective Program Updates, see details below
1. RSVP Now for the 8th Annual PIPC Forum!
The 8th annual PIPC Forum will take place December 13 from 12:30-2:30 at the Reserve Officers Association (1 Constitution Avenue NE). This year, we will discuss how alternative payment models can support care that patients value. With the announcement of a New Direction for the CMMI, PIPC looks forward to hearing from CMS on how their future work can instill principles of patient-centeredness into payment models. We also look forward to a panel that discusses the role of patients in developing innovative payment models, how CMMI can support payment models that embrace a culture of patient-centeredness, and how patient-centered care can bend the cost curve by avoiding the adverse events that emanate from a “fail first” mentality in health care. Our panel will include experts on shared decision-making, patient engagement and innovative payment models both in Medicare and the VA. You can RSVP directly to [email protected]
2. PIPC Responds to HHS Notice of Benefit and Payment Parameters for 2019
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." Click here to read the letter.
3. PIPC Submits Comments to CMS Regarding RFI on New Direction for CMMI
The Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) seeking insights on a new direction to promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes. In response, the Chairman Tony Coelho of the Partnership to Improve Patient Care (PIPC) applauded CMS and Administrator Verma for making strong statements in support of patients and patient-centered care, and releasing an RFI to set a new direction for the Center for Medicare and Medicaid Innovation that supports patients, caregivers and people with disabilities. PIPC has long advocated for CMMI to engage patients and people with disabilities early in the development of patient-centered demonstrations that have the potential to improve patient outcomes while lowering costs. As part of the effort to move CMMI in a new direction, Chairman Coelho urges CMMI to establish meaningful mechanisms for patients and people with disabilities to engage in the development of these models. He also urges CMS to develop meaningful patient-centeredness criteria that would enable CMMI and the public to determine whether APMs are truly putting patients first. PIPC is reviewing the RFI in more detail and looks forward to working with CMMI on a new direction that puts patients at the center. Click here to read the letter.
Additionally, the Personalized Medicine Coalition (PMC) submitted a comment letter to CMS stressing the value of personalized medicine to patients and the health system. “CMS' previous efforts to advance new payment models, the letter notes, were met with resistance largely because they focused on reducing overall health care costs without adequately considering whether those reductions would result in a disproportionate decrease in the outcomes that matter to patients. We believe that personalized medicine has the potential to help CMS deliver on its goal of [affordable, accessible health care] if [the agency] focuses on maximizing individual patient outcomes, if new models are fully evaluated before large-scale implementation, if payment is not rooted in current standard of care, and if physicians have the flexibility to tailor care based on a patient's genetics and other factors." Click here to read the letter.
4. Letter to VA: Tell VA to Rely on Veterans to Define Health Value - not QALYs!
Over 40 representatives of veterans, patients and people with disabilities wrote to VA Secretary Shulkin regarding their concerns about the Institute for Clinical and Economic Review’s (ICER) agreement to work with the Department of Veterans Affairs (VA) Pharmacy Benefits Management Services office (PBM) to support its use of ICER drug assessment reports. In the letter, the signers urged the VA to adopt a model that puts patients first. The letter points out that ICER utilizes a quality-adjusted-life-year (QALY) metric as the basis for its value assessments that is very controversial for its potentially discriminatory impact on people with disabilities and serious chronic conditions. In 1992, the U.S. Department of Health and Human Services determined the use of QALYs to determine Oregon’s prioritized list of services in Medicaid to be discriminatory. The letter stated, "Alternatively, we strongly support an infrastructure for our engagement to ensure that the health system delivers value to veterans and their caregivers, with the goal of achieving outcomes that matter to them. Veterans with disabilities and serious chronic conditions want to have a strong role in coverage and formulary decisions to ensure that coverage reflects the real world needs of veterans. We want to help the VA be a model for putting patients first.” Click here to read the letter.
5. Letter to the Editor: We should move past stereotypes about older adults
PIPC Steering member Sue Peschin with the Alliance for Aging Research responded to a Washington Post opinion titled “Time to Take Baby Boomers Off the Ticket.” She responds that we should be moving past stereotypes about older adults, and points out the value of increased social expertise from accumulated experience and knowledge, as well as higher levels of gratitude, forgiveness, calmness and appreciation. Click here to read the letter.
6. The PCORI Blog: Empowering COPD Patients to Better Manage Their Symptoms
Hanan Aboumatar offers patient-centered suggestions that would help COPD patients better manage their symptoms. “...Most hospitals use a 30-day transition plan that focuses on helping patients address issues that commonly arise after they leave the hospital. But these plans don't provide guidance to help patients manage their long-term health, leaving them and caregivers like my patient's daughter anxious and unsure of how to manage the condition back at home. The project I lead is investigating whether a longer-term, patient-centered program would slow the revolving door of hospital readmissions, improve patients' quality of life, and reduce stress for caregivers.” Click here to read the blog.
7. PatientEngagementHIT: Do Patient-Centered Medical Homes Boost Chronic Care Management?
Sara Heath notes in PatientEngagementHIT that the patient-centered medical home model improved outcomes measures for chronic care management patients. “The study looked at a VA-sponsored PCMH initiative titled the Patient Aligned Care Teams (PACT) program. The program launched in 2010 and was the largest of its kind at the time. PACT introduced PCMH principles to over 800 clinics. Each participating clinic had equal access to resources and education about the PACT model. The model emphasized key aspects of patient engagement and patient-centered care, including patient access, continuity, coordination, team-based care, comprehensiveness of care, self-management support, patient-centered communication and shared decision-making.” Click here to read the article.
8. Upcoming Events and Webinars
Patient and Stakeholder Engagement in Research: Engagement Challenges, Strategies and Resources
December 5, 2017
Click here for details.
PCORI in Practice Webinar: Employers' Use of Patient-Centered Research
December 6, 2017
Click here for details.
The Next Wave in Adaptive Biomedical Innovation: Advancing Platform Trials into End-to-End Rapid Learning Systems
December 12-13, 2017
Click here for details.
Advisory Panel on Addressing Disparities Fall 2017 Meeting
December 14, 2017
Click here for details.
Advisory Panel on Improving Healthcare Systems Fall 2017 Meeting
December 14, 2017
Click here for details.
9. Medical Journal Articles
Including the Patient Voice in Patient-Centered Outcomes Research in Integrative Oncology, click here to view.
Patient and Provider Perspectives on Shared Decision Making: A Systematic Review of the Peer-Reviewed Literature, click here to view.
Gene Therapy: Evidence, Value and Affordability in the US Health Care System, click here to view.
Patient Value: Perspectives from the Advocacy Community, click here to view.
The Added Value of Integrate-HTA Guidance in the Work Processes of Health Technology Assessment Agencies, click here to view.
Practicalities Of Using Real-World Evidence (RWE) In Comparative Effectiveness Research (CER): Learnings From Imi-Getreal, click here to view.
The Role of Condition-Specific Preference-Based Measures in Health Technology Assessment, click here to view.
Hospital Cost Impact of Orbital Atherectomy with Angioplasty for Critical Limb Ischemia Treatment: A Modeling Approach, click here to view.
Real-World Evidence: Useful in the Real World of US Payer Decision Making? How? When? And What Studies? Click here to view.
Targeted Identification of Adverse Events in Coronary Artery Disease Patients Based on Patient-Reported Outcomes, click here to view.
Use of Patient-Reported Outcomes and Satisfaction for Quality Assessments, click here to view.
Patient-Reported Outcomes in Cancer Care — Hearing the Patient Voice at Greater Volume, click here to view.
10. AHRQ Effective Program Updates
Management of Insomnia Disorder - Consumer and Clinician Summaries, click here to view
Harms of First-Line Depression Treatment in Older Adults, click here to view.
Management of Renal Masses and Localized Renal Cell Carcinoma: Current State of the Evidence - Clinician Summary, click here to view.
Stroke Prevention in Atrial Fibrillation Patients: A Systematic Review Update, click here to view.
Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update, click here to view.
Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update -- Research Protocol, click here to view.
Drug Therapy for Early Rheumatoid Arthritis in Adults – An Update -- Research Protocol, click here to view.
Psychological and Pharmacological Treatments for Adults with Posttraumatic Stress Disorder (PTSD): A Systematic Review Update -- Research Protocol, click here to view
Tympanostomy Tubes in Children with Otitis Media -- Final Report, click here to view
Treatment of Osteoarthritis of the Knee: An Update Review -- Final Report, click here to view.
Assessment Tools for Palliative Care -- Final Report, click here to view.
Noninvasive, Nonpharmacological Treatment for Chronic Pain, click here to view.
The Role of Immunotherapy in the Treatment of Asthma, click here to view
The 8th annual PIPC Forum will take place December 13 from 12:30-2:30 at the Reserve Officers Association (1 Constitution Avenue NE). This year, we will discuss how alternative payment models can support care that patients value. With the announcement of a New Direction for the CMMI, PIPC looks forward to hearing from CMS on how their future work can instill principles of patient-centeredness into payment models. We also look forward to a panel that discusses the role of patients in developing innovative payment models, how CMMI can support payment models that embrace a culture of patient-centeredness, and how patient-centered care can bend the cost curve by avoiding the adverse events that emanate from a “fail first” mentality in health care. Our panel will include experts on shared decision-making, patient engagement and innovative payment models both in Medicare and the VA. You can RSVP directly to [email protected]
2. PIPC Responds to HHS Notice of Benefit and Payment Parameters for 2019
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." Click here to read the letter.
3. PIPC Submits Comments to CMS Regarding RFI on New Direction for CMMI
The Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) seeking insights on a new direction to promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes. In response, the Chairman Tony Coelho of the Partnership to Improve Patient Care (PIPC) applauded CMS and Administrator Verma for making strong statements in support of patients and patient-centered care, and releasing an RFI to set a new direction for the Center for Medicare and Medicaid Innovation that supports patients, caregivers and people with disabilities. PIPC has long advocated for CMMI to engage patients and people with disabilities early in the development of patient-centered demonstrations that have the potential to improve patient outcomes while lowering costs. As part of the effort to move CMMI in a new direction, Chairman Coelho urges CMMI to establish meaningful mechanisms for patients and people with disabilities to engage in the development of these models. He also urges CMS to develop meaningful patient-centeredness criteria that would enable CMMI and the public to determine whether APMs are truly putting patients first. PIPC is reviewing the RFI in more detail and looks forward to working with CMMI on a new direction that puts patients at the center. Click here to read the letter.
Additionally, the Personalized Medicine Coalition (PMC) submitted a comment letter to CMS stressing the value of personalized medicine to patients and the health system. “CMS' previous efforts to advance new payment models, the letter notes, were met with resistance largely because they focused on reducing overall health care costs without adequately considering whether those reductions would result in a disproportionate decrease in the outcomes that matter to patients. We believe that personalized medicine has the potential to help CMS deliver on its goal of [affordable, accessible health care] if [the agency] focuses on maximizing individual patient outcomes, if new models are fully evaluated before large-scale implementation, if payment is not rooted in current standard of care, and if physicians have the flexibility to tailor care based on a patient's genetics and other factors." Click here to read the letter.
4. Letter to VA: Tell VA to Rely on Veterans to Define Health Value - not QALYs!
Over 40 representatives of veterans, patients and people with disabilities wrote to VA Secretary Shulkin regarding their concerns about the Institute for Clinical and Economic Review’s (ICER) agreement to work with the Department of Veterans Affairs (VA) Pharmacy Benefits Management Services office (PBM) to support its use of ICER drug assessment reports. In the letter, the signers urged the VA to adopt a model that puts patients first. The letter points out that ICER utilizes a quality-adjusted-life-year (QALY) metric as the basis for its value assessments that is very controversial for its potentially discriminatory impact on people with disabilities and serious chronic conditions. In 1992, the U.S. Department of Health and Human Services determined the use of QALYs to determine Oregon’s prioritized list of services in Medicaid to be discriminatory. The letter stated, "Alternatively, we strongly support an infrastructure for our engagement to ensure that the health system delivers value to veterans and their caregivers, with the goal of achieving outcomes that matter to them. Veterans with disabilities and serious chronic conditions want to have a strong role in coverage and formulary decisions to ensure that coverage reflects the real world needs of veterans. We want to help the VA be a model for putting patients first.” Click here to read the letter.
5. Letter to the Editor: We should move past stereotypes about older adults
PIPC Steering member Sue Peschin with the Alliance for Aging Research responded to a Washington Post opinion titled “Time to Take Baby Boomers Off the Ticket.” She responds that we should be moving past stereotypes about older adults, and points out the value of increased social expertise from accumulated experience and knowledge, as well as higher levels of gratitude, forgiveness, calmness and appreciation. Click here to read the letter.
6. The PCORI Blog: Empowering COPD Patients to Better Manage Their Symptoms
Hanan Aboumatar offers patient-centered suggestions that would help COPD patients better manage their symptoms. “...Most hospitals use a 30-day transition plan that focuses on helping patients address issues that commonly arise after they leave the hospital. But these plans don't provide guidance to help patients manage their long-term health, leaving them and caregivers like my patient's daughter anxious and unsure of how to manage the condition back at home. The project I lead is investigating whether a longer-term, patient-centered program would slow the revolving door of hospital readmissions, improve patients' quality of life, and reduce stress for caregivers.” Click here to read the blog.
7. PatientEngagementHIT: Do Patient-Centered Medical Homes Boost Chronic Care Management?
Sara Heath notes in PatientEngagementHIT that the patient-centered medical home model improved outcomes measures for chronic care management patients. “The study looked at a VA-sponsored PCMH initiative titled the Patient Aligned Care Teams (PACT) program. The program launched in 2010 and was the largest of its kind at the time. PACT introduced PCMH principles to over 800 clinics. Each participating clinic had equal access to resources and education about the PACT model. The model emphasized key aspects of patient engagement and patient-centered care, including patient access, continuity, coordination, team-based care, comprehensiveness of care, self-management support, patient-centered communication and shared decision-making.” Click here to read the article.
8. Upcoming Events and Webinars
Patient and Stakeholder Engagement in Research: Engagement Challenges, Strategies and Resources
December 5, 2017
Click here for details.
PCORI in Practice Webinar: Employers' Use of Patient-Centered Research
December 6, 2017
Click here for details.
The Next Wave in Adaptive Biomedical Innovation: Advancing Platform Trials into End-to-End Rapid Learning Systems
December 12-13, 2017
Click here for details.
Advisory Panel on Addressing Disparities Fall 2017 Meeting
December 14, 2017
Click here for details.
Advisory Panel on Improving Healthcare Systems Fall 2017 Meeting
December 14, 2017
Click here for details.
9. Medical Journal Articles
Including the Patient Voice in Patient-Centered Outcomes Research in Integrative Oncology, click here to view.
Patient and Provider Perspectives on Shared Decision Making: A Systematic Review of the Peer-Reviewed Literature, click here to view.
Gene Therapy: Evidence, Value and Affordability in the US Health Care System, click here to view.
Patient Value: Perspectives from the Advocacy Community, click here to view.
The Added Value of Integrate-HTA Guidance in the Work Processes of Health Technology Assessment Agencies, click here to view.
Practicalities Of Using Real-World Evidence (RWE) In Comparative Effectiveness Research (CER): Learnings From Imi-Getreal, click here to view.
The Role of Condition-Specific Preference-Based Measures in Health Technology Assessment, click here to view.
Hospital Cost Impact of Orbital Atherectomy with Angioplasty for Critical Limb Ischemia Treatment: A Modeling Approach, click here to view.
Real-World Evidence: Useful in the Real World of US Payer Decision Making? How? When? And What Studies? Click here to view.
Targeted Identification of Adverse Events in Coronary Artery Disease Patients Based on Patient-Reported Outcomes, click here to view.
Use of Patient-Reported Outcomes and Satisfaction for Quality Assessments, click here to view.
Patient-Reported Outcomes in Cancer Care — Hearing the Patient Voice at Greater Volume, click here to view.
10. AHRQ Effective Program Updates
Management of Insomnia Disorder - Consumer and Clinician Summaries, click here to view
Harms of First-Line Depression Treatment in Older Adults, click here to view.
Management of Renal Masses and Localized Renal Cell Carcinoma: Current State of the Evidence - Clinician Summary, click here to view.
Stroke Prevention in Atrial Fibrillation Patients: A Systematic Review Update, click here to view.
Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update, click here to view.
Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update -- Research Protocol, click here to view.
Drug Therapy for Early Rheumatoid Arthritis in Adults – An Update -- Research Protocol, click here to view.
Psychological and Pharmacological Treatments for Adults with Posttraumatic Stress Disorder (PTSD): A Systematic Review Update -- Research Protocol, click here to view
Tympanostomy Tubes in Children with Otitis Media -- Final Report, click here to view
Treatment of Osteoarthritis of the Knee: An Update Review -- Final Report, click here to view.
Assessment Tools for Palliative Care -- Final Report, click here to view.
Noninvasive, Nonpharmacological Treatment for Chronic Pain, click here to view.
The Role of Immunotherapy in the Treatment of Asthma, click here to view
