26 Aug The Task Force Writes to CMS Administrator Brooks-LaSure
The Health Care Transformation Task Force (“HCTTF” or “Task Force”) looks forward to working with Administrator Brooks-LaSure and the CMS team to advance a value-based delivery system that focuses on providing affordable, equitable, person-centered care. The following recommendations represent the Task Force’s priorities for the new Administration and CMS leadership:
- A Strategic Vision Is Needed to Realize the Potential of Value-Based Payment: Realizing the potential of payment transformation requires the current Administration to set a strategic vision for advancing value-based payment and care delivery efforts in Medicare and Medicaid. Task Force staff is on record with a series of other recommendations in a February 2020 Health Affairs blog: The Center for Medicare and Medicaid Innovation Can Be A Powerful Force for Change, But Not Without Key Reforms and we appreciate the recent Health Affairs blog authored by CMS leaders on the future of CMMI and the vision for the next ten years. We urge CMS to provide stakeholders an opportunity to provide public comments in response to these vision statements. CMS should promote a value-based payment ecosystem focused on models with broad provider participation that integrate well with other models.
- Value-Based Payment Initiatives Should Address Health Inequities, Disparities and Other Systemic Weaknesses Laid Bare by COVID-19: We commend CMS and CMMI for indicating that addressing health equity will be the cornerstone of the Administration’s mission. CMS should develop policies that require Medicare and Medicaid providers and plans to collect and make publicly available disaggregated data by race, ethnicity, subgroup, and other important factors. CMMI should place greater emphasis on addressing the social determinants (or drivers) of health (SDoH) that too often create roadblocks to individuals’ health and health care, with the goal of promoting better population health for all communities. We believe that an interagency effort across all relevant federal departments that identifies and coordinates on common policy objectives and pursues blending and braiding of relevant funding streams to address SDoH has the potential to be a key initiative for the Biden Administration.
- CMS Should Seek New Ways to Ensure that Patients and Consumers Are at the Center of their Health Care: Task Force led the convening of a Consumer Roundtable in that focused on discussing effective consumer engagement strategies and the priorities of consumer organizations and look forward to continuing those meetings. We are pleased that CMMI has expressed interest in HCTTF convening separate listening sessions that focus on strategies health care organizations have pursued to achieve their patient-centeredness goals and sharing learnings on what has worked and what has fallen short.
- CMMI Should Support and Accelerate State-Led and Multi-Payer Value Transformation: We strongly urge CMMI to make more significant investments in testing new models of value-based payment and care delivery that address the holistic needs of the Medicaid population, including behavioral health and social needs, and advance health equity through community partnerships. CMMI should dedicate resources to transforming how maternal health care is delivered. The Medicaid program, which pays for about half of all births in the country, provides a great opportunity to test and encourage adoption of alternatives to fee-for-service for maternity payment.
- Other Medicare Policies Should Support Value-based Payment Transformation: Policymakers should reimagine payment policies and model methodologies to better account for these important elements of value-based care and make corresponding payment adjustments to cover these costs. Although an unpopular idea with many, CMS should also develop an off ramp that disincentivizes providers from remaining in fee-for-service.