Coalition sends Tom Price suggestions to reform CMMI

Signs saying healthcare reform
A coalition of national healthcare organizations has proposed six principles to reform the Center for Medicare and Medicaid Innovation. Image: Getty/Eugenia Chaikina

A coalition of national healthcare industry groups wants Department of Health and Human Services Secretary Tom Price to address concerns about the Center for Medicare and Medicaid Innovation while staying true to CMMI’s goal of fostering new reforms.

Healthcare Leaders for Accountable Innovation in Medicare has sought reforms to CMMI that ensure its projects include proper data sharing and are transparent, appropriately scaled and collaborative with private entities, according to an announcement from the coalition.

For Price's part, he said during his Senate nomination proceedings that he’s “adamantly opposed” to the mandatory way CMMI has approached some demonstrations.

RELATED: Tom Price stresses patient choice, state innovation

“We need a CMMI, but we also need safeguards to ensure that CMMI adheres to its original intent," Mary Grealy, president of the Healthcare Leadership Council, said in the announcement. Those safeguards must also make sure that the agency tests innovative payment and delivery approaches "without harm to those who deliver and receive healthcare," she said.

To achieve that goal, the coalition outlined six principles for CMMI:

  • Any testing must follow a scientifically valid approach that includes a transparent plan and promotes voluntary, not forced, participation
  • Congress must approve any demonstration model expansions and related changes to Medicare and Medicaid
  • CMMI must engage consistently with key stakeholders by making transparent the process for developing and testing new models
  • The Center must make data from its model tests public so that private entities can gauge their impacts on quality and potentially apply those reforms at their own organizations
  • It must ensure patients are educated and aware of these projects and how they could impact care
  • It should work in tandem with stakeholders in the private sector by giving priority to partnerships with payers, providers and other private entities

The coalition is made up of 35 organizations, including CAPG, the Joint Commission, the National Association of ACOs and the American Psychiatric Association.