Clinician and beneficiary engagement key to future of Quality Payment Program

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The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program lies at the heart of the agency’s plan to pay providers for care quality rather than the volume of services they deliver. While much of the program development to date has encompassed technological innovation, Jean Moody-Williams, deputy director of the Center for Clinical Standards and Quality at the agency, says engaging with clinicians and patients will be a key step in developing the final program.

In an interview for QIO News, Moody-Williams emphasized the need to “level the playing field and include new partners in technology development,” namely, practicing physicians and Medicare beneficiaries. To do so, she says, the program must “ensure that beneficiaries are getting care that meets their needs in a coordinated fashion and that technologies are open and flexible, helping to innovate and improve care.”

The Quality Innovation Network Quality Improvement Organizations (QIN-QIOs), which have done much of the heavy lifting to date in terms of shifting payment methodologies, will continue to play a key role by helping clinicians to understand the impact of the changes ahead of them, or how new policies or requirements can work for them, according to Moody-Williams. QIN-QIOs also serve an important purpose as a conduit between CMS and physicians, allowing them to recommend improvements CMS could make as well as to direct clinicians toward resources and coach them on best practices, she says.

On the clinical side, Moody-Williams sees alternative payment models outlined in the Medicare Access and CHIP Reauthorization Act of 2015 as a concrete example of the type of endpoint toward which the Quality Payment Program is driving. “In short, we want to make sure that people get the best care, stay healthy, and that we are smart about how we are spending money,” she says.