The Medicare Access and CHIP Reauthorization Act (MACRA) is the biggest change to how Medicare pays for services in decades. It will accelerate the movement towards value-based payments—where what health care providers get paid depends, at least partially, on the quality of care they provide, not just the volume of services. On June 27, Families USA submitted comments about how the law will be implemented.
As drug prices continue to rise at an unsustainable rate, we must ensure that our health care system and its financial incentives enhance the quality and value of care. We believe the Medicare Part B prescription drug model proposed by the Centers for Medicare & Medicaid Services (CMS) creates value for the patient and the program by encouraging treatment choices that have been shown to improve care and health outcomes.
Last Wednesday, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to implement key provisions of the Medicare Access & CHIP Reauthorization Act. Passed with bipartisan support in 2015, MACRA represents is an important opportunity to improve the quality of care delivered through Medicare. Given the number of people who are enrolled in Medicare and the number of providers who see Medicare patients, these changes will have a significant impact throughout the entire health care system.
Recent actions by the Center for Medicare and Medicaid Services (CMS) represent an encouraging recognition–by one of the biggest payers of health care in the nation—that one-size-fits all payment reforms do not benefit everyone equally.
And they raise the question of whether some of these pay-for-performance programs should be adjusted to better address racial and ethnic health disparities.
By now the benefits of Medicaid expansion are well known. In addition to providing health coverage to millions of Americans, it has helped create new health care jobs, decrease hospitals’ spending on uncompensated care, and generate budget savings for states. But another benefit is often overlooked: Medicaid expansion can help improve the quality of health care and reduce costs throughout a state’s entire health care system, not just in Medicaid.
Black History Month inspires us to celebrate the rich history, achievements, and contributions of African Americans in our nation, as well as the hard work that remains to dismantle racism and achieve true racial equality. We agree with Dr. King that fighting injustice in health care is an urgent civil rights issue central to achieving our shared dream of peace, prosperity, and equality for our children. But it is clear that a focus on health care alone will not achieve health equity for African Americans.
A set of principles laying out Families USA’s vision for health system transformation that achieves the triple aim of better care, lower cost, and better health. Health care stakeholders can use these to inform policy decisions.
Families USA and the Institute for Clinical and Economic Review (ICER) have produced a new series of consumer guides to help patients and clinicians focus on which tests or treatments to choose when several reasonable options exist.
In early January, the Center for Medicare and Medicaid Innovation announced its first program focused on addressing a patient’s social needs. This 5-year, $157 million pilot program, called Accountable Health Communities, will try to bridge the gap between clinical and social services, testing whether addressing these needs can improve health, lower costs, and improve quality for Medicare and Medicaid beneficiaries.
Americans spend more money per capita on health care than any other country, yet there is little evidence to suggest that we get a higher quality of care for that extra money. Indeed, far too often, Americans receive substandard quality of care. So, what can we do about it? In order to improve health care, we need to be able to measure its effectiveness.
Measuring the quality of health care can improve care for consumers in five ways: