A group of influential healthcare industry executives is asking President-elect Donald Trump and other incoming policymakers to keep and prioritize value-based care models, which have been championed under the Affordable Care Act.
“This is not the time for policymakers to waver or reverse course, which would send a negative message to the industry and chill ongoing transformation efforts,” reads the letter made public Wednesday by the Health Care Transformation Task Force.
The letter appeals to traditional Republican priorities like reducing Medicare and Medicaid spending, promoting public-private partnerships and encouraging new and existing businesses. It is addressed to Trump, Vice President-elect Mike Pence, House and Senate leaders of both parties, the nominee for HHS secretary, Tom Price, and nominee for CMS administrator, Seema Verma.
The Health Care Transformation Task Force is a group of 43 heavy-hitters including hospitals, doctors, health insurance companies and patient advocates and focuses on promoting value-based care instead of the current fee-for-service system.
Jeff Micklos, executive director of the task force, said key aspects of the letter are reminding the incoming administration that the movement toward value-based care—like accountable care organizations and other payment models that are tied to quality outcomes—has always been bipartisan and that it cannot be left on the back burner.
“Even inaction is really a concern,” he said.
Micklos said the task force wants to make sure other health policy issues like Trump's promise to repeal the Affordable Care Act don't push issues like implementing the Medicare Access and CHIP Reauthorization Act, or MACRA, off the agenda. If that happens, investments companies have made in new care models will be at risk, Micklos said.
“What doesn't necessarily get a lot of exposure and what we're bringing to light here is the level of innovation that is happening in the private landscape,” he said.
The letter calls for the continued use of the Center for Medicare and Medicaid Innovation, also known as the CMS Innovation Center, to test payment models. The center has received some criticism from Republicans, including Price, for implementing models with mandatory provider participation.
Micklos said a platform for studying new payment models is necessary, and Republicans could use the Innovation Center to test models using their own methods and priorities.
David Lansky, CEO of the Pacific Business Group on Health and task force member, said employers are concerned that not moving forward with value-based models would lead to higher, unsustainable costs and sicker employees.
“Competitiveness depends on control of healthcare costs and healthy workers,” Lansky said.
Task force member Dr. Angelo Sinopoli, vice president of clinical integration and chief medical officer of Greenville (S.C.) Health System, said a simple statement from new leaders that they will support alternative payment models would be a good start to open dialogue.
“Unless we get a signal from the new transition team that they are going to continue to focus on efficient and market-based solutions to taking care of patients, I think we could creep back to a model where the cost of care actually goes up rather than down,” he said.