• Strengthening Innovation in Medicare and Medicaid Act Would Impede Progress Toward Value-Based Care

    Monday, February 10, 2020

    Statement attributable to:
    Gary LeRoy, MD
    American Academy of Family Physicians

    “The American Academy of Family Physicians opposes HR 5741, the Strengthening Innovation in Medicare and Medicaid Act, a bill that would undermine meaningful progress in the shift toward value-based care. The Center for Medicare & Medicaid Innovation (CMMI) has been an important source of innovation that has accelerated the pace of transformation toward value-based care—especially for primary care—and this legislation, if enacted, would be a major step backward.

    “The very purpose of CMMI was to give the federal government an agile and streamlined way to test, promote and scale successful payment and delivery system reforms. CMMI has not only transformed Medicare payments, but it has been a catalyst for private sector and state-led initiatives as well. While well intentioned, HR 5741 would have a chilling effect on that progress. 

    “HR 5741 would fundamentally alter CMMI’s authority by imposing a level of bureaucracy that would stifle care transformation through requiring congressional approval at all phases of a model, arbitrary model parameters and expansion requirements, and burdensome reporting requirements.  

    “The AAFP fully supports transparency and responsible stewardship of Medicare resources and feels that HR 5741 would actually waste resources by forcing the already limited CMMI staff to devote energy to bureaucratic processes rather than focusing on developing and testing models. This additional paperwork burden could slow, if not halt, the release of new models.

    “Family physicians are on the frontlines delivering care in our communities and have partnered in good faith to shift to a system that fosters innovation and provides better outcomes. Nearly 70% of all primary care practices participating in CMMI’s Comprehensive Primary Care Plus initiative included family physicians. This model has led to significant improvements in care delivery which would not have been possible without the resources and convening power of CMMI. 

    “Even more family physicians are eager to participate in alternative payment models that reward value over volume, and the AAFP would like to see more new models being tested by CMMI, not fewer. Congress passed the bipartisan Medicare Access and CHIP Reauthorization Act (MACRA) to incentivize clinicians to participate in advanced alternative payment models, and CMMI is the primary source of those opportunities. HR 5741 would limit the scope of future CMMI models and prevent the timely release of new models which in turn limits the number of physicians able to participate.

    “With a shared interest in moving from the outdated fee-for-service model of care to alternative payment models, Congress should be doing all it can to support testing various ways to achieve this goal. HR 5741 would throw a wrench in the engine of CMMI’s progress.”


    Editor's Note: To arrange an interview with Dr. LeRoy, contact Megan Moriarty, 800-274-2237, Ext. 6052, or mmoriarty@aafp.org.

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    Founded in 1947, the American Academy of Family Physicians represents 134,600 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

    Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

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