Today, the Health Policy Commission’s subcommittee on Care Delivery and Payment System Reform met for the first time. Present at the meeting were David Cutler, Marylou Sudders, Jean Yang, Carole Allen (by telephone), and David Seltz. Wendy Everett was present as a guest. Sudders facilitated the meeting.
The first order of business was to elect a Subcommittee chair. Allen was nominated and unanimously approved. Sudders continued to facilitate the meeting since Allen could not be physically present. Sudders noted the five overarching responsibilities of the subcommittee:
- Establish a provider organization registration program
- Develop and implement standards for a certification program of Patient-Centered Medical Homes (PCMH) and Accountable Care Organizations (ACOs) and develop model payment standards to support PCMHs.
- Administer a competitive grant program to foster the development and evaluation of innovative health care delivery, payment models and quality of care measures.
- Coordinate with public and private payers regarding the advancement, adoption and measurement of alternative payment methodologies.
- Coordinate with the Division of Insurance regarding the development of regulations related to the certification of risk-bearing provider organizations.
Next, David Seltz was asked to go over some pressing deliverables. He said that this subcommittee would be guided by several overarching principles. They are charged with moving away from fee for service and toward methods that support value, quality, are patient-centered, and integrate mental health. One timely item Seltz noted was the development of regulations related to the certification of risk-bearing provider organizations. DOI has already started this process but provider orgs will need to register with the HPC. This subcommittee needs to contemplate what information it would like to collect from provider orgs and coordinate with other state agencies to develop a registration program.
Yang would like to spend time at the next meeting to fully define “risk bearing provider organizations.” Cutler said he would like to focus on responsibilities 3 and 4 (noted above) and set up joint working groups to coordinate with other government agencies and would like to form working groups with the provider and insurance communities to develop common standards helpful to everyone’s goals. Everett suggested that a senior analyst make a list of all public and private certification requirements. Seltz noted that some of this information has already been collected by DOI. Seltz said that the HPC must set standards for patient centered medical homes by January 1, 2014. By July 1, 2012, the Office of Medicaid must set up a training program for PCMHs and HPC must develop a payment system for PCMHs. Sudders noted that NCQA standards would provide a good starting point for PCMHs standards and that she would like to see different stakeholders define what “integration” means to them.
Seltz announced that the HPC is now staffed by four people and that he would introduce them at the next full HPC meeting. Cutler would like to set up an internal process for creating standards. Seltz agreed that this was a good idea, given that the January 1, 2014 deadline was fast approaching. Seltz also intends to look outside the HPC to different experts for guidance on this matter. Moving to responsibility 3 (noted above), Seltz said that HPC will have money for a grants when the first gaming license is sold. He wants to create a grant distribution system In anticipation of this money so that HPC can hit the ground running.
Setting up agenda items for the next meeting: Cutler wants to create a timeline for the subcommittee and Yang wants some concrete steps added to the timeline. Sudder noted that all future agenda items would have to be coordinated with the new chair—Allen.
Lastly, the floor was opened for public comment. A consumer and patient representative commented that the subcommittee should coordinate with consumers and integrate consumers into decisions. A representative from MAHP suggested that the subcommittee review alternative payment methodologies with CHIA. A representative from Atrius Health suggested that, in advance of listening sessions with stakeholders, the subcommittee should send out specific questions. A Partners Health representative suggested that the subcommittee form an advisory council to get information that subcommittee needs. The Atrius Health representative added that the subcommittee should reach out to different organizations and actively inform them of developments. Cutler suggested that she and other people send in lists of organizations to David Seltz for the subcommittee to contact. An MHA representative suggested that the subcommittee use their website to clarify regulations, like through FAQs.