{"id":21133,"date":"2018-11-11T05:51:08","date_gmt":"2018-11-11T10:51:08","guid":{"rendered":"https:\/\/participatorymedicine.org\/epatients\/?p=21133"},"modified":"2018-11-11T05:51:08","modified_gmt":"2018-11-11T10:51:08","slug":"cms-use-patient-experts-in-measure-development-but-dont-pay-them","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2018\/11\/cms-use-patient-experts-in-measure-development-but-dont-pay-them.html","title":{"rendered":"CMS: Use Patient Experts in Measure Development, but Don’t Pay Them?"},"content":{"rendered":"

CMS (Center for Medicare and Medicaid)’s work on Value-Based Measures<\/strong><\/a> matters for patients and caregivers because we seek affordable, accessible, equitable, and effective medical care. Or in English: Transparent cost within my means, in a location I can reach, in a fair and unbiased manner, for care that is likely to move me and mine toward best health. We, patient\/caregiver experts, need a seat at the tables of governance, design, operations, and learning in the medical industrial complex to advocate for that kind of care.<\/p>\n

I sat in one such seat (ten of twenty members represented the patient perspective!) on a CMS TEP (Technical Expert Panel). Here’s a blog post I wrote about it Oct 2017<\/a> and here’s the associated final CMS report<\/a>. As I wrote in that post, Payment for medical services is shifting from paying for volume (more visits, tests, visits, days = more money) to\u00a0<\/i>paying for value<\/i><\/a>\u00a0(quality of care). Makes sense. But what does value and quality of care mean? It means that physicians get paid an incentive (more money) for certain results (outcomes, process, actions). An example is\u00a0readmission\u00a0rates. If a physician\u2019s patients are readmitted to a hospital after discharge more than most physicians, they don\u2019t get the extra payment. There are roughly 1,000 of such\u00a0<\/i>quality measures<\/i><\/a>. These quality measures are very important to us \u2013\u00a0people at the center of care\u00a0(patients, caregivers, parents, direct care clinicians, and staff) \u2013 because measurement strongly influences people and organizations who get paid for medical services. Following the money doesn\u2019t necessarily mean better medical care, better health for us, better relationships among our healthcare teams, or better work life for our health professional partners.<\/i><\/p>\n

The Panel completed its work in July and CMS just published the final report from the Panel. We did good work, our recommendations were heard!<\/p>\n

TEP Recommendations for Adding Value and Efficiency to the Measure Development Process<\/a><\/p>\n

Important to us, People at the Center of Care, are the following recommendations:<\/p>\n