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Young Stands Up For ACA-Funded CMS Innovation Center During Price Confirmation Hearing

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https://www.c-span.org/video/?421723-1/hhs-nominee-representative-tom-price-testifies-capitol-hill

During a Senate grilling of Health and Human Services Secretary nominee Tom Price at the Georgia Representative’s confirmation hearing this week, Indiana Senator Todd Young expressed support for a lesser-known part of the Affordable Care Act.

The Center for Medicare and Medicaid Innovation is funded through the ACA, which gives the center $10 billion through 2019 and an additional $10 billion for each subsequent decade. The “CMMI” tinkers with payment models across the nation and is sometimes referred to as a “test kitchen” for finding more cost-effective and efficient payment structures. Demonstrations—basically experiments—have focused on both administrative cost-saving measures, such as bundling hospital payments, as well as ways to improve patient care, such as coordinating treatment among providers.

Some such demonstrations require hospitals and doctors to participate, such as a study that began in 2015 called the Comprehensive Care Joint Replacement Model. The CJR, which examines cost-bundling payments for hip, and knee replacements, takes place in 800 hospitals nation-wide.

Price, an orthopedic surgeon, was an outspoken critic of the CJR. Last year, Price and other members of congress sent a letterto the Centers for Medicare and Medicaid Services calling for the end of required participation in CMMI demonstrations, writing “CMMI’s mandatory models ‘experiment’ with thousands of patient lives without prior testing on a smaller scale or even a basic indication that they will actually achieve improved quality, or at the very least, maintain present quality.”

During Price’s appearance before the Senate Health, Education, Labor and Pensions Committee, Senator Young expressed support for the CMMI in a question to Price.

I think CMMI is and can continue to be a helpful laboratory for healthcare experimentation,” Young said, when asking him about his views on the organization. “We see what doesn’t work, and we scale up what does work. For me, it’s common sense. This is the way that scientists operate.”

In a short answer, Price doubled down on his view against mandatory participation.

“In every single experiment, healthcare experiment or medical experiment or scientific experiment that deals with people, we demand, we require, that there be informed consent,” said Price.

Price said he’d like to continue the demonstrations, but would want to give patients the ability to choose to take part. If those smaller pilots proved successful, he says the measures could then be “scaled up” nation-wide.

A Young spokesman says the senator agrees with Price and doesn’t want healthcare mandates to, in his words, “come between Hoosiers and their doctors.”

Young also used his time during the confirmation to ask Price about his views on Indiana’s Medicaid expansion, HIP 2.0.

“The Medicaid program is one where the states know best how to care for their Medicaid population,” said Price. “What Indiana has done is really a best-practice for many other states to follow.”

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