Premier : Releases Recommendations to Improve Healthcare Policy

To download the recommendations, click here: https://www.premierinc.com/wp-content/uploads/2016/09/RoadMap2016_09_19_Final.pdf

For slide version, click here: https://www.premierinc.com/policy-roadmap-v4/

Advocates for more flexibility to enable innovation, cost reduction and continuous quality improvement among health systems

WASHINGTON, D.C. (September 19, 2016) -Premier Inc. (NASDAQ: PINC), a leading healthcare improvement company, today released nine categories of recommendations designed to enhance the current framework for healthcare policy. These reforms are designed to provide a holistic approach to achieving a high-quality, cost-effective healthcare system.

'While we have come a long way on our journey toward a reformed delivery system with value-based payment models, we've also uncovered some unintended consequences,' said Blair Childs, senior vice president of public affairs at Premier. 'Some current policies, while well-intended, are overlapping, confusing and sometimes unfair. Premier's recommendations present a more comprehensive framework that removes barriers standing in the way of higher quality, more efficient and coordinated care.'

In its work with thousands of hospitals, health systems and physician groups across the country, Premier has actively tested, measured and scaled value-based care delivery models that enable innovation, cost reduction and continuous quality improvement. A number of large-scale, data-driven healthcare initiatives, including Premier's accountable care, bundled payment and QUEST collaboratives, have allowed Premier to understand what works for different patient populations. Based on these valuable insights, Premier recommends the following public policy changes be implemented in combination or as stand-alone reforms.

• Accountable Care Organizations (ACOs): Refine the Medicare Shared Savings Program (MSSP) to ensure the continued success of ACOs. Reforms like permanent payment waivers, additional shared savings for top performers, relief from sequestration and more flexibility to move up the risk continuum for Medicare ACOs are urgently needed.
• Legal And Regulatory Barriers to Integrated Care: Remove the legal and regulatory barriers that thwart providers' efforts to achieve better care for individuals, better population health and lower healthcare costs by amending fraud and abuse laws and policies such as the site of service regulations. Broad exceptions to the anti-kickback, civil monetary penalties and Stark physician self-referral laws are needed to protect ACOs, regardless of whether those ACOs participate in Medicare ACO programs.
• Data Access: Paramount to success, data access should move closer to real-time access of not only Medicare, but timely Medicaid, Veteran's Administration and Department of Defense data used for healthcare operations, research and commercial purposes that improve care while protecting beneficiaries' privacy.
• Layered Payment Model Demonstration: As an additional choice for providers participating in alternative payment models, implement a new blended payment model pilot to test primary care capitation coupled with bundled payments within Medicare ACOs.
• Interoperable Health Information Technology: Through use of standards and application programming interfaces, electronic health record (EHR) systems must move from being closed, inaccessible information silos to open, interoperable medical records on which applications may be written, easing the reliable exchange of information among care providers and patients.
• Consolidation of Hospital Pay for Performance Programs: Pay-for-performance programs should hold providers accountable on areas within their control without creating duplicative penalties. A single, consolidated hospital pay-for-performance program is needed to replace the five separate, contradictory programs currently instated.
• Critical Access Hospital Value‐Based Purchasing Program: Rural areas must not be left behind, but brought into delivery system reform through tailored programs that work in low-population density areas. A pilot program testing and scaling value-based purchasing incentives with critical access hospitals needs to be created to encourage participation from such institutions that are currently exempt from similar programs.
• Beneficiary Engagement: Beneficiary engagement techniques should be embedded in all aspects of each program, such as measurement, transparency efforts, benefit design and payment. New beneficiary engagement tools such as co-pay waivers, transportation vouchers and in-home technologies should be allowable and encouraged.
• Provider-Based Outpatient Clinics: Site-neutral payment policies need to broadly consider how the use of provider-based clinics may help support an overall reduction in healthcare spending and improve the coordination and quality of care to patients. In particular, ACOs that own or operate provider-based clinics to coordinate care across the continuum and manage population health should be exempt from site-neutral payment.

'With a new Administration and a new Congress coming in 2017, now is the time to hit the reset button and make some common sense changes to the current laws. Enacting these policy reforms will ensure that we continue to build a consumer-driven, accountable healthcare system,' said Childs. 'We look forward to engaging with policymakers and other industry leaders to build on these ideas.'

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