Dave TerryIn September 2017, Seema Verma, administrator for the Centers for Medicare & Medicaid Services (CMS), announced “a new direction” for the agency’s innovation arm, the Center for Medicare & Medicaid Innovation (CMMI). Along with the announcement, CMS solicited feedback from healthcare stakeholders on how CMMI should move forward in its new era. The key message to Verma’s announcement was that bundled payments and other innovative care models are a focus for the agency.

Now, seven months and 4,600 pages later, CMS has released the feedback. Providers, patients, health plans, associations, innovators, and partners jumped on the opportunity to share thoughts and recommendations. The level of engagement from healthcare stakeholders—more than 1,000 comments, according to CMS—signals that the industry continues to have strong opinions about value-based care. 

Much of the feedback centered on enhancing the patient experience, increasing accountability for outcomes among providers, and increasing overall transparency. 

As a follow-up to the comments, CMS has issued another RFI on implementing a model (or models) for direct provider contracting (DPC) and is now accepting comments about the approach until May 25. DPC, routed in primary care capitation, would aim to “enhance the beneficiary-physician relationship by providing a platform for physician group practices to provide flexible, accessible, and high-quality care to beneficiaries that have actively chosen this type of care model” CMS says.  While it’s encouraging to see CMS spotlight physician-led models and find new ways to engage smaller independent practices, there are a lot of questions surrounding the model, including which services should be included and how CMS will ensure access to care for sicker and more complex patient populations. 

The fact that feedback from the healthcare industry after the September announcement spurred CMS to action demonstrates the strength in numbers. The best changes in health care come from healthy discussion, even debate, within the industry. Whether the issue at hand is payment reform, issues of access to care, or care delivery, having critical conversations and offering innovative solutions is what moves us forward.   


Dave Terry is CEO and co-founder at Archway Health, Watertown, Mass.

Publication Date: Tuesday, May 22, 2018