A New Bill May Slow Down Experimental Payment Models

The Strengthening Innovation in Medicare and Medicaid Act—HR 5741—would require the HHS secretary to keep track of how a demonstration model affects beneficiaries’ access to care. HHS would also have to monitor the effects of delivery and payment changes on healthcare disparities and alleviate related issues that could negatively affect health outcomes.

Among many changes, the most notable is that providers could seek hardship exemptions from Medicare’s Innovation Center (CMMI) if they would be subject to undue economic hardship or if the agency’s requirements caused vulnerable populations to lose access to specific providers.

Providers are all too aware of the impact of CMMI’s “creative” payment models. Although these programs are started with good intentions, often reimbursement is too low and the cost of compliance is too high. Patients, communities, and providers all lose when half-baked programs force providers out of business.

Click here to read the full story from Modern Healthcare, and click here to read the bill.

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